Provider Demographics
NPI:1902554561
Name:LIGGINS, DEJAH SHANIYAH
Entity Type:Individual
Prefix:
First Name:DEJAH
Middle Name:SHANIYAH
Last Name:LIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2756
Mailing Address - Country:US
Mailing Address - Phone:240-603-5382
Mailing Address - Fax:
Practice Address - Street 1:5927 FISHER RD APT 102
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-5914
Practice Address - Country:US
Practice Address - Phone:301-541-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula