Provider Demographics
NPI:1548747025
Name:GIDEON, FEBEN
Entity Type:Individual
Prefix:
First Name:FEBEN
Middle Name:
Last Name:GIDEON
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 1:1117 DUNOON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1609
Mailing Address - Country:US
Mailing Address - Phone:301-335-6440
Mailing Address - Fax:
Practice Address - Street 1:8701 GEORGIA AVE STE 411
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3713
Practice Address - Country:US
Practice Address - Phone:301-392-7075
Practice Address - Fax:301-576-5487
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst