Provider Demographics
NPI:1205678927
Name:GYASI, MAMAYAA (CPRP)
Entity type:Individual
Prefix:MS
First Name:MAMAYAA
Middle Name:
Last Name:GYASI
Suffix:
Gender:F
Credentials:CPRP
Other - Prefix:MS
Other - First Name:MAYAA
Other - Middle Name:
Other - Last Name:GYASI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPRP
Mailing Address - Street 1:711 BIRCHLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1804
Mailing Address - Country:US
Mailing Address - Phone:202-375-1955
Mailing Address - Fax:
Practice Address - Street 1:4805 GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5695
Practice Address - Country:US
Practice Address - Phone:443-869-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty