Provider Demographics
NPI:1225475205
Name:ANOKAM, PAUL KEMAKOLAM (HHA)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:KEMAKOLAM
Last Name:ANOKAM
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:KEMAKOLAM
Other - Last Name:ANOKAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HHA
Mailing Address - Street 1:5615 ELLERBIE ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2429
Mailing Address - Country:US
Mailing Address - Phone:240-305-1633
Mailing Address - Fax:
Practice Address - Street 1:5615 ELLERBIE ST
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2429
Practice Address - Country:US
Practice Address - Phone:240-305-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst