MEDICARE: JESSICA AKYAA ANIM-WIAFE MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1275190787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA AKYAA ANIM-WIAFE MA

Provider Business Mailing Address
First Line	:	671 HOES LN W
Second Line	:
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-8021
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 ADAMS LN APT 1A
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-2557
Country	:	US
Telephone Number	:	732-235-4823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	05/21/2019

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