Healthcare Provider Details

I. General information

NPI: 1447184189
Provider Name (Legal Business Name): STELLA NAHBILA MBOTIJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12609 NICHOLS PROMISE DR
BOWIE MD
20720-5602
US

IV. Provider business mailing address

12609 NICHOLS PROMISE DR
BOWIE MD
20720-5602
US

V. Phone/Fax

Practice location:
  • Phone: 240-432-9565
  • Fax:
Mailing address:
  • Phone: 240-432-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: