Provider Demographics
NPI:1790318970
Name:OREVBA, NAOMI O
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:O
Last Name:OREVBA
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 1:7474 GREENWAY CENTER DR STE 700B
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3523
Mailing Address - Country:US
Mailing Address - Phone:240-304-3327
Mailing Address - Fax:240-513-4155
Practice Address - Street 1:7474 GREENWAY CENTER DR STE 700B
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3523
Practice Address - Country:US
Practice Address - Phone:240-304-3327
Practice Address - Fax:240-513-4155
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD241641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical