Provider Demographics
NPI:1609645415
Name:SAFFA, MARIAMA IJEOMA
Entity type:Individual
Prefix:MS
First Name:MARIAMA
Middle Name:IJEOMA
Last Name:SAFFA
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 1:3112 RIVER BEND CT # 304
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2970
Mailing Address - Country:US
Mailing Address - Phone:410-564-8804
Mailing Address - Fax:
Practice Address - Street 1:3112 RIVER BEND CT # 304
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2970
Practice Address - Country:US
Practice Address - Phone:410-564-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
DCLC2000027001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical