Healthcare Provider Details

I. General information

NPI: 1710412895
Provider Name (Legal Business Name): PAULA AKANNI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 10/22/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 ANNAPOLIS RD
LANHAM MD
20706-2060
US

IV. Provider business mailing address

9836 FARM POND RD
LAUREL MD
20708-6001
US

V. Phone/Fax

Practice location:
  • Phone: 202-531-6233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: