Provider Demographics
NPI:1841074366
Name:NYAJENA, PAIDAMOYO AUDREY
Entity type:Individual
Prefix:
First Name:PAIDAMOYO
Middle Name:AUDREY
Last Name:NYAJENA
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 1:936 WINDBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3251
Mailing Address - Country:US
Mailing Address - Phone:530-414-5554
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR STE 108
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6419
Practice Address - Country:US
Practice Address - Phone:240-296-5862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health