Provider Demographics
NPI:1588451231
Name:TEFERA, MATTHEW ADUGNA
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ADUGNA
Last Name:TEFERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HALFPENNY LN
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1150
Mailing Address - Country:US
Mailing Address - Phone:443-657-3547
Mailing Address - Fax:
Practice Address - Street 1:708 PINE DRIFT DR
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2504
Practice Address - Country:US
Practice Address - Phone:443-558-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician