Provider Demographics
NPI:1669332425
Name:ELEANOR ESSENG MEH KA, FNU
Entity type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:ELEANOR ESSENG MEH KA
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 1:11401 WINDY HARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3460
Mailing Address - Country:US
Mailing Address - Phone:240-350-1220
Mailing Address - Fax:
Practice Address - Street 1:11401 WINDY HARBOR WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3460
Practice Address - Country:US
Practice Address - Phone:240-350-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-14
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD10272680166106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician