Provider Demographics
NPI:1225705114
Name:DRAYTON, JOMANI PATRICIA CATRINA
Entity Type:Individual
Prefix:
First Name:JOMANI
Middle Name:PATRICIA CATRINA
Last Name:DRAYTON
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 1:1676 MARYLAND AVE NE APT 652E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7780
Mailing Address - Country:US
Mailing Address - Phone:202-875-4267
Mailing Address - Fax:
Practice Address - Street 1:1676 MARYLAND AVE NE APT 652E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7780
Practice Address - Country:US
Practice Address - Phone:202-875-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10853104100000X
MD26514104100000X
DCLG50083369104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker