Provider Demographics
NPI:1932698610
Name:MOWLANA, FATHIMA FARHA (LCPC)
Entity Type:Individual
Prefix:
First Name:FATHIMA
Middle Name:FARHA
Last Name:MOWLANA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5806 EDSON LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2981
Mailing Address - Country:US
Mailing Address - Phone:410-961-6607
Mailing Address - Fax:
Practice Address - Street 1:5806 EDSON LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2981
Practice Address - Country:US
Practice Address - Phone:410-961-6607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8266101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty