Provider Demographics
NPI:1396548228
Name:MULAT, HAREGEWOIN ABEBE
Entity type:Individual
Prefix:
First Name:HAREGEWOIN
Middle Name:ABEBE
Last Name:MULAT
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 1:101 NORWICK CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5112
Mailing Address - Country:US
Mailing Address - Phone:240-713-9561
Mailing Address - Fax:
Practice Address - Street 1:101 NORWICK CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5112
Practice Address - Country:US
Practice Address - Phone:240-713-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0700X
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging