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General NPI Number Information
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NPI Number | 1013865666
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Entity Type | Individual
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Provider Name | ASAAH ANYAMA MOFOR INGRID
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Gender | Male
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 1509 MADISON ST APT 203
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City | CHILLUM
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State | MD
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Zip | 20782-2525
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Country | US
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Telephone | 301-643-6706
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Fax |
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Provider Business Mailing Address
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Address Line | 6612 IAN ST
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3630
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Country | US
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Telephone | 301-643-6706
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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