Healthcare Provider Details

I. General information

NPI: 1497668644
Provider Name (Legal Business Name): PATIENCE JUWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5457 TWIN KNOLLS RD STE 300
COLUMBIA MD
21045-3296
US

IV. Provider business mailing address

6212 41ST AVE
HYATTSVILLE MD
20782-2104
US

V. Phone/Fax

Practice location:
  • Phone: 410-885-6223
  • Fax:
Mailing address:
  • Phone: 240-505-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: