Provider Demographics
NPI:1568282473
Name:BABY, OUMA IDRISSA
Entity type:Individual
Prefix:
First Name:OUMA
Middle Name:IDRISSA
Last Name:BABY
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 1:14105 CASTLE BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4728
Mailing Address - Country:US
Mailing Address - Phone:301-201-6218
Mailing Address - Fax:
Practice Address - Street 1:1400 SPRING ST STE 101
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2735
Practice Address - Country:US
Practice Address - Phone:240-398-3514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician