Healthcare Provider Details
I. General information
NPI: 1801394556
Provider Name (Legal Business Name): STELLA A UKAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/29/2018
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 ANNAPOLIS RD STE B2
LANHAM MD
20706-2062
US
IV. Provider business mailing address
9500 ANNAPOLIS RD STE B2
LANHAM MD
20706-2062
US
V. Phone/Fax
- Phone: 301-850-1148
- Fax: 866-250-3233
- Phone: 301-850-1148
- Fax: 866-250-3233
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: