Provider Demographics
NPI:1912752288
Name:NDOYE, FATMATA
Entity Type:Individual
Prefix:
First Name:FATMATA
Middle Name:
Last Name:NDOYE
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 1:4233 58TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1938
Mailing Address - Country:US
Mailing Address - Phone:240-960-4963
Mailing Address - Fax:
Practice Address - Street 1:4233 58TH AVE APT 5
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1938
Practice Address - Country:US
Practice Address - Phone:240-960-4963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1-10-78521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical