Provider Demographics
NPI:1801292560
Name:UDOH, MAYEN M (MS)
Entity type:Individual
Prefix:
First Name:MAYEN
Middle Name:M
Last Name:UDOH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
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Mailing Address - Street 1:5606 SHIELDS DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3571
Mailing Address - Country:US
Mailing Address - Phone:301-493-0023
Mailing Address - Fax:301-493-8230
Practice Address - Street 1:412 1ST ST SE
Practice Address - Street 2:LOWER LEVEL REAR ENTRANCE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1804
Practice Address - Country:US
Practice Address - Phone:202-470-4185
Practice Address - Fax:877-350-8028
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst