Provider Demographics
NPI:1407296031
Name:GRAYMAN, NYASHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NYASHA
Middle Name:
Last Name:GRAYMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 REISTERSTOWN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7126
Mailing Address - Country:US
Mailing Address - Phone:667-206-3685
Mailing Address - Fax:
Practice Address - Street 1:1829 REISTERSTOWN RD STE 350
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7126
Practice Address - Country:US
Practice Address - Phone:667-206-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
MDLC12281101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist