Provider Demographics
NPI:1497008338
Name:AMIBANG, CATHERINE KONDO (HHA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:KONDO
Last Name:AMIBANG
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 BERLEIGH HILL CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1391
Mailing Address - Country:US
Mailing Address - Phone:240-468-6033
Mailing Address - Fax:301-558-6014
Practice Address - Street 1:3707 BERLEIGH HILL CT
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1391
Practice Address - Country:US
Practice Address - Phone:240-468-6033
Practice Address - Fax:301-558-6014
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2016101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor