Provider Demographics
NPI:1649024332
Name:HOWARD, NYEENA DENINE
Entity type:Individual
Prefix:
First Name:NYEENA
Middle Name:DENINE
Last Name:HOWARD
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 1:210 CREST VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6306
Mailing Address - Country:US
Mailing Address - Phone:678-830-4978
Mailing Address - Fax:
Practice Address - Street 1:761 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9352
Practice Address - Country:US
Practice Address - Phone:678-810-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst