Provider Demographics
NPI:1003513680
Name:SEDESSE, NARIAH DALEEAH (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:NARIAH
Middle Name:DALEEAH
Last Name:SEDESSE
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360595
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6595
Mailing Address - Country:US
Mailing Address - Phone:718-215-5311
Mailing Address - Fax:718-865-5165
Practice Address - Street 1:806 LANDMARK DR STE 117-121
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4980
Practice Address - Country:US
Practice Address - Phone:718-865-5165
Practice Address - Fax:718-865-5165
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician