Provider Demographics
NPI:1205404753
Name:DUMESSA, LEDIYA
Entity Type:Individual
Prefix:
First Name:LEDIYA
Middle Name:
Last Name:DUMESSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SILVER SPRING AVE APT 115
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-5085
Mailing Address - Country:US
Mailing Address - Phone:615-720-5991
Mailing Address - Fax:
Practice Address - Street 1:915 SILVER SPRING AVE APT 115
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-5085
Practice Address - Country:US
Practice Address - Phone:615-720-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist