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General NPI Number Information
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NPI Number | 1013785914
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Entity Type | Individual
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Provider Name | HAJA IYE JABBA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 4100 E CAPITOL ST NE
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City | WASHINGTON
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State | DC
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Zip | 20019-3367
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Country | US
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Telephone | 202-718-4784
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Fax |
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Provider Business Mailing Address
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Address Line | 6903 SAINT ANNES AVE
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City | LANHAM
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State | MD
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Zip | 20706-3400
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Country | US
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Telephone | 407-924-0928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | J100329718740
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License Number State | FL
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