Provider Demographics
NPI:1467161828
Name:HADDISH, SABA BERHA
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:BERHA
Last Name:HADDISH
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 1:1401 WHITTIER PL NW APT 106
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2823
Mailing Address - Country:US
Mailing Address - Phone:202-569-9330
Mailing Address - Fax:
Practice Address - Street 1:1401 WHITTIER PL NW APT 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2823
Practice Address - Country:US
Practice Address - Phone:202-569-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200002352374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide