Provider Demographics
NPI:1457079618
Name:BAH, FATMATA LAMARANA (PMHNP)
Entity Type:Individual
Prefix:
First Name:FATMATA
Middle Name:LAMARANA
Last Name:BAH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12073 TECH RD STE B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7874
Mailing Address - Country:US
Mailing Address - Phone:240-701-6113
Mailing Address - Fax:
Practice Address - Street 1:12073 TECH RD STE B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7874
Practice Address - Country:US
Practice Address - Phone:240-701-6113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR226255163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent