Provider Demographics
NPI:1790520054
Name:JAPHET, FIBIYA
Entity type:Individual
Prefix:
First Name:FIBIYA
Middle Name:
Last Name:JAPHET
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 1:5530 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-4030
Mailing Address - Country:US
Mailing Address - Phone:301-401-5379
Mailing Address - Fax:
Practice Address - Street 1:5530 WALNUT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4030
Practice Address - Country:US
Practice Address - Phone:301-401-5379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst