Healthcare Provider Details

I. General information

NPI: 1053005488
Provider Name (Legal Business Name): DELPHINE NAHBILA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 BLADENSBURG RD NE
WASHINGTON DC
20002-2922
US

IV. Provider business mailing address

11505 CORALROOT CT
BOWIE MD
20721-2259
US

V. Phone/Fax

Practice location:
  • Phone: 202-507-8139
  • Fax:
Mailing address:
  • Phone: 240-342-9697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: