Provider Demographics
NPI:1750056743
Name:BABI, STEPHANIE EKWEN
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:EKWEN
Last Name:BABI
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 1:440 WARFIELD DR APT 4124
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4691
Mailing Address - Country:US
Mailing Address - Phone:240-432-5062
Mailing Address - Fax:
Practice Address - Street 1:440 WARFIELD DR APT 4124
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4691
Practice Address - Country:US
Practice Address - Phone:240-432-5062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00193953171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator