Healthcare Provider Details

I. General information

NPI: 1447172945
Provider Name (Legal Business Name): ABEBE TEKLEMARIAM WOLDEMARIAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9093 RIDGEFIELD DR STE 207
FREDERICK MD
21701-6712
US

IV. Provider business mailing address

31 SCARLET SAGE CT
BURTONSVILLE MD
20866-1156
US

V. Phone/Fax

Practice location:
  • Phone: 240-457-9595
  • Fax:
Mailing address:
  • Phone: 240-232-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: