Provider Demographics
NPI:1013489392
Name:NURIDEEN, AALIYAH
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:
Last Name:NURIDEEN
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 1:5348 CENTRAL AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-6412
Mailing Address - Country:US
Mailing Address - Phone:908-432-2519
Mailing Address - Fax:
Practice Address - Street 1:2850 N RIDGE RD STE 210
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3463
Practice Address - Country:US
Practice Address - Phone:410-203-1649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06429900104100000X
NJ44SC060159901041C0700X
MD277941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker