MEDICARE: YONATA NEGATU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	BACB414207	MD

General Provider Information

NPI Number	:	1356849921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YONATA NEGATU

Provider Business Mailing Address
First Line	:	2119 BLUE KNOB TER
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-6200
Country	:	US
Telephone Number	:	240-839-0172
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 BLUE KNOB TER
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-6200
Country	:	US
Telephone Number	:	240-839-0172
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2018
Last Update Date	:	01/29/2018

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Directions to “ YONATA NEGATU ” Practice Location

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