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General NPI Number Information
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NPI Number | 1700608718
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Entity Type | Individual
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Provider Name | NYAIR RENA WASHINGTON LGPC
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 5200 MARLBORO PIKE
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-5424
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Country | US
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Telephone | 253-549-3735
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Fax | --
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Provider Business Mailing Address
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Address Line | 10206 TWISTED STALK CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-4526
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP15575
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License Number State | MD
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