Provider Demographics
NPI:1467155275
Name:HEGBE, ORNELLA AMEN
Entity Type:Individual
Prefix:
First Name:ORNELLA
Middle Name:AMEN
Last Name:HEGBE
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 1:7520 MAPLE AVE APT 216
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4943
Mailing Address - Country:US
Mailing Address - Phone:240-437-1188
Mailing Address - Fax:
Practice Address - Street 1:7520 MAPLE AVE APT 216
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4943
Practice Address - Country:US
Practice Address - Phone:240-437-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000015701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical