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General NPI Number Information
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NPI Number | 1730929217
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Entity Type | Individual
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Provider Name | TABETH AGHAJI-ENWEREMADU LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 3331 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4597
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Country | US
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Telephone | 703-552-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 20 FAWN HILL RD
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City | TUXEDO PARK
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State | NY
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Zip | 10987-3514
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Country | US
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Telephone | 516-996-7805
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0903004173
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License Number State | VA
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