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General NPI Number Information
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NPI Number | 1174497499
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Entity Type | Organization
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Legal Business Name | MINDFUL MOMENTS
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1609 10TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22204-4770
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Country | US
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Telephone | 240-685-1965
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Fax |
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Provider Business Mailing Address
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Address Line | 4135 WHEELER RD SE
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City | WASHINGTON
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State | DC
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Zip | 20032-4302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GM
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Name | DAWIT GIZAW
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Credential |
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Telephone | 240-685-1965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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