Provider Demographics
NPI:1902670367
Name:PENLAND, JHIYA
Entity Type:Individual
Prefix:
First Name:JHIYA
Middle Name:
Last Name:PENLAND
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 1:5497 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-6361
Mailing Address - Country:US
Mailing Address - Phone:678-755-8526
Mailing Address - Fax:
Practice Address - Street 1:5497 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-6361
Practice Address - Country:US
Practice Address - Phone:678-755-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician