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General NPI Number Information
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NPI Number | 1659948990
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Entity Type | Individual
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Provider Name | KALKIDAN YILMA
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Gender | Female
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 11/18/2023
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Provider Practice Location Address
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Address Line | 4401 E WEST HWY # 504
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City | BETHESDA
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State | MD
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Zip | 20814-4523
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Country | US
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Telephone | 240-647-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 9711 WASHINGTONIAN BLVD
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City | GAITHERSBURG
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State | MD
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Zip | 20878-7365
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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 |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 30733
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License Number State | MD
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