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General NPI Number Information
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NPI Number | 1457246456
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Entity Type | Individual
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Provider Name | JA'NIEYAH MISHERRE JA'NAY AVILA
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Gender | Female
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 7500 GREENWAY CENTER DR STE 1300
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City | GREENBELT
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State | MD
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Zip | 20770-3575
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Country | US
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Telephone | 301-585-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 7845 BRANDY STATION RD
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City | HANOVER
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State | MD
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Zip | 21076-2414
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Country | US
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Telephone | 470-717-9944
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Fax | 470-717-9944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-442666
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License Number State | MD
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