Healthcare Provider Details

I. General information

NPI: 1164359667
Provider Name (Legal Business Name): ANDREW NAWA MAKINA RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19540 AMARANTH DR, GERMANTOWN, MD 20874
GERMANTOWN MD
20874
US

IV. Provider business mailing address

19540 AMARANTH DR
GERMANTOWN MD
20874-1202
US

V. Phone/Fax

Practice location:
  • Phone: 240-830-7233
  • Fax:
Mailing address:
  • Phone: 844-244-1818
  • 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: