Provider Demographics
NPI:1710482468
Name:KWARTEMAH, ADWOA
Entity Type:Individual
Prefix:
First Name:ADWOA
Middle Name:
Last Name:KWARTEMAH
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 1:4129 CATLETT RD
Mailing Address - Street 2:
Mailing Address - City:CATLETT
Mailing Address - State:VA
Mailing Address - Zip Code:20119-2163
Mailing Address - Country:US
Mailing Address - Phone:571-201-6160
Mailing Address - Fax:
Practice Address - Street 1:4129 CATLETT RD
Practice Address - Street 2:
Practice Address - City:CATLETT
Practice Address - State:VA
Practice Address - Zip Code:20119-2163
Practice Address - Country:US
Practice Address - Phone:157-120-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
4519OtherVIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES