Provider Demographics
NPI:1467043091
Name:DJINKO, MOYA ALICE ESTHER
Entity Type:Individual
Prefix:MRS
First Name:MOYA
Middle Name:ALICE ESTHER
Last Name:DJINKO
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 1:816 THAYER AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4593
Mailing Address - Country:US
Mailing Address - Phone:301-755-6107
Mailing Address - Fax:301-755-6105
Practice Address - Street 1:816 THAYER AVE FL 1
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4593
Practice Address - Country:US
Practice Address - Phone:301-755-6107
Practice Address - Fax:301-755-6105
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child