Provider Demographics
NPI:1669162806
Name:DJIGUI SUPPORT, INC
Entity type:Organization
Organization Name:DJIGUI SUPPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OUATTARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-550-3118
Mailing Address - Street 1:10410 KENSINGTON PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2950
Mailing Address - Country:US
Mailing Address - Phone:240-760-9313
Mailing Address - Fax:301-888-8256
Practice Address - Street 1:10410 KENSINGTON PKWY STE 109
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2950
Practice Address - Country:US
Practice Address - Phone:240-760-9313
Practice Address - Fax:301-888-8256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities