Provider Demographics
NPI:1881561892
Name:EHANA, ETINOSASERE VALERIE
Entity type:Individual
Prefix:
First Name:ETINOSASERE
Middle Name:VALERIE
Last Name:EHANA
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 1:101 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MD
Mailing Address - Zip Code:21716-1804
Mailing Address - Country:US
Mailing Address - Phone:301-635-2273
Mailing Address - Fax:
Practice Address - Street 1:50 W EDMONSTON DR STE 306
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1280
Practice Address - Country:US
Practice Address - Phone:301-635-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician