Healthcare Provider Details

I. General information

NPI: 1861257388
Provider Name (Legal Business Name): HABIBAT BIOBAKU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 REISTERSTOWN RD
BALTIMORE MD
21208-4325
US

IV. Provider business mailing address

9716 ANITA LN
LANHAM MD
20706-3307
US

V. Phone/Fax

Practice location:
  • Phone: 410-541-1316
  • Fax:
Mailing address:
  • Phone: 301-536-3089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: