Healthcare Provider Details

I. General information

NPI: 1306643986
Provider Name (Legal Business Name): GLORY AJIUWAI NJOIKOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 BRIGHTLEA DR
LANHAM MD
20706-2866
US

IV. Provider business mailing address

6320 BRIGHTLEA DR
LANHAM MD
20706-2866
US

V. Phone/Fax

Practice location:
  • Phone: 301-454-9457
  • Fax:
Mailing address:
  • Phone: 301-454-9457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number200004522
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: