Provider Demographics
NPI:1083144422
Name:WILLIFORD, AYANA
Entity Type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:WILLIFORD
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 1:4765 SAINT BRIDES ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3129
Mailing Address - Country:US
Mailing Address - Phone:240-682-1457
Mailing Address - Fax:
Practice Address - Street 1:1615 RHODE ISLAND AVE NORTHEAST
Practice Address - Street 2:
Practice Address - City:WASHINGTON D.C.
Practice Address - State:DC
Practice Address - Zip Code:20003-2000
Practice Address - Country:US
Practice Address - Phone:240-535-8013
Practice Address - Fax:240-535-8013
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20587104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker