Provider Demographics
NPI:1164169868
Name:MARTIN HARRIDAY, NYAZIA AYANNA
Entity type:Individual
Prefix:
First Name:NYAZIA
Middle Name:AYANNA
Last Name:MARTIN HARRIDAY
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 1:6325 DANNER DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3865
Mailing Address - Country:US
Mailing Address - Phone:240-605-7334
Mailing Address - Fax:
Practice Address - Street 1:2526 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6719
Practice Address - Country:US
Practice Address - Phone:202-748-5641
Practice Address - Fax:202-748-5647
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician