Provider Demographics
NPI:1508653502
Name:ACKAH, NOBERTA ABENA
Entity type:Individual
Prefix:
First Name:NOBERTA
Middle Name:ABENA
Last Name:ACKAH
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 1:14601 TYNEWICK TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2667
Mailing Address - Country:US
Mailing Address - Phone:347-238-7157
Mailing Address - Fax:
Practice Address - Street 1:14601 TYNEWICK TER
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2667
Practice Address - Country:US
Practice Address - Phone:347-238-7157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician