Provider Demographics
NPI:1881917250
Name:RASHADA, OMAR N (MS)
Entity type:Individual
Prefix:MR
First Name:OMAR
Middle Name:N
Last Name:RASHADA
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MARYLAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805
Mailing Address - Country:US
Mailing Address - Phone:302-655-7108
Mailing Address - Fax:302-655-4822
Practice Address - Street 1:1901 MARLAND AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:WILMNIGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-655-7108
Practice Address - Fax:302-655-4822
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE101YM0800X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health