Provider Demographics
NPI:1831915453
Name:HYTEN, AJAH BRANDISE (MS)
Entity type:Individual
Prefix:
First Name:AJAH
Middle Name:BRANDISE
Last Name:HYTEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 W. HORIZON RIDGE PWKY
Mailing Address - Street 2:UNIT 201A & 201B
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052
Mailing Address - Country:US
Mailing Address - Phone:702-363-7284
Mailing Address - Fax:
Practice Address - Street 1:2298 W. HORIZON RIDGE PWKY
Practice Address - Street 2:UNIT 201A & 201B
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-363-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4442106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist