Healthcare Provider Details

I. General information

NPI: 1801762190
Provider Name (Legal Business Name): MRS. HEWAN KIROS GEBREHIWOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 EUGENIE CT
NEW ORLEANS LA
70131-8602
US

IV. Provider business mailing address

31 EUGENIE CT
NEW ORLEANS LA
70131-8602
US

V. Phone/Fax

Practice location:
  • Phone: 504-810-2268
  • Fax:
Mailing address:
  • Phone: 504-810-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number007533990
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: