Provider Demographics
NPI:1770003360
Name:MA'AT, AIYANA K
Entity Type:Individual
Prefix:
First Name:AIYANA
Middle Name:K
Last Name:MA'AT
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:PO BOX 73188
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20056-3188
Mailing Address - Country:US
Mailing Address - Phone:202-341-0500
Mailing Address - Fax:877-637-7491
Practice Address - Street 1:1100 VERMONT AVE NW STE 520
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-6342
Practice Address - Country:US
Practice Address - Phone:202-341-0500
Practice Address - Fax:877-637-7491
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500797271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical