Provider Demographics
NPI:1730711755
Name:SAWANEH, SALIMATU ISATA
Entity type:Individual
Prefix:
First Name:SALIMATU
Middle Name:ISATA
Last Name:SAWANEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5331 85TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3214
Mailing Address - Country:US
Mailing Address - Phone:240-713-0001
Mailing Address - Fax:
Practice Address - Street 1:5331 85TH AVE APT 102
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3214
Practice Address - Country:US
Practice Address - Phone:240-713-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional