Provider Demographics
NPI:1659987873
Name:ALEMNEW, MAHLET MOGES
Entity Type:Individual
Prefix:
First Name:MAHLET
Middle Name:MOGES
Last Name:ALEMNEW
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 1:2718 CURRY DR
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1724
Mailing Address - Country:US
Mailing Address - Phone:301-803-8407
Mailing Address - Fax:
Practice Address - Street 1:2718 CURRY DR
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1724
Practice Address - Country:US
Practice Address - Phone:301-803-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health