Provider Demographics
NPI:1407650906
Name:BIDDANDA, HALEY C (EDD, NCSP)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:C
Last Name:BIDDANDA
Suffix:
Gender:
Credentials:EDD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 READING AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1517
Mailing Address - Country:US
Mailing Address - Phone:315-945-8002
Mailing Address - Fax:
Practice Address - Street 1:11721 KEMP MILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1722
Practice Address - Country:US
Practice Address - Phone:240-740-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3624103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool