MEDICARE: HAREGEWOIN ABEBE MULAT

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	103TA0700X	Adult Development & Aging Psychologist
2	374U00000X	Home Health Aide		DC

General Provider Information

NPI Number	:	1396548228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAREGEWOIN ABEBE MULAT

Provider Business Mailing Address
First Line	:	101 NORWICK CT
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-5112
Country	:	US
Telephone Number	:	240-713-9561
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 NORWICK CT
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-5112
Country	:	US
Telephone Number	:	240-713-9561
Fax Number	:

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

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	04/09/2025

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