Provider Demographics
NPI:1609159201
Name:GBONDO, WUYAH PHYLIS
Entity Type:Individual
Prefix:MS
First Name:WUYAH
Middle Name:PHYLIS
Last Name:GBONDO
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 1:9103 WOODMORE CENTER DR STE 659
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1653
Mailing Address - Country:US
Mailing Address - Phone:301-793-0361
Mailing Address - Fax:
Practice Address - Street 1:3401 LINDENWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724
Practice Address - Country:US
Practice Address - Phone:301-793-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29334104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker