Provider Demographics
NPI:1730871773
Name:DJARBENG, MIRIAM AFALEY
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:AFALEY
Last Name:DJARBENG
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 1:4 MILFORD GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2978
Mailing Address - Country:US
Mailing Address - Phone:443-565-2603
Mailing Address - Fax:
Practice Address - Street 1:4 MILFORD GARDEN CT
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2978
Practice Address - Country:US
Practice Address - Phone:443-565-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician