Provider Demographics
NPI:1649675166
Name:AJANAKU, KILOLO (MPA, DSPR)
Entity type:Individual
Prefix:
First Name:KILOLO
Middle Name:
Last Name:AJANAKU
Suffix:
Gender:F
Credentials:MPA, DSPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 LOST SPRING CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3834
Mailing Address - Country:US
Mailing Address - Phone:240-353-3483
Mailing Address - Fax:
Practice Address - Street 1:7212 LOST SPRING CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3834
Practice Address - Country:US
Practice Address - Phone:240-353-3483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health