Provider Demographics
NPI:1962284455
Name:MUHASHYI, KANSIIME DOROTHY
Entity type:Individual
Prefix:
First Name:KANSIIME DOROTHY
Middle Name:
Last Name:MUHASHYI
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 1:10 GLADHILL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7892
Mailing Address - Country:US
Mailing Address - Phone:240-259-1128
Mailing Address - Fax:
Practice Address - Street 1:10 GLADHILL DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:MD
Practice Address - Zip Code:21769-7892
Practice Address - Country:US
Practice Address - Phone:240-259-1128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00000000000000000101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty