=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962284455
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KANSIIME DOROTHY MUHASHYI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2023
-----------------------------------------------------
Last Update Date | 03/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 GLADHILL DR
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21769-7892
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-259-1128
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 GLADHILL DR
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21769-7892
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-259-1128
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 00000000000000000
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------