Provider Demographics
NPI:1346722592
Name:WOLDAI, DELAILA D
Entity Type:Individual
Prefix:
First Name:DELAILA
Middle Name:D
Last Name:WOLDAI
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 1:4416 RENN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2745
Mailing Address - Country:US
Mailing Address - Phone:240-472-8940
Mailing Address - Fax:
Practice Address - Street 1:1 RESEARCH CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3221
Practice Address - Country:US
Practice Address - Phone:888-557-1305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician