Provider Demographics
NPI:1700584216
Name:NJAGUA, JANE WANGUI
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:WANGUI
Last Name:NJAGUA
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 1:2203 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1109
Mailing Address - Country:US
Mailing Address - Phone:443-253-0972
Mailing Address - Fax:
Practice Address - Street 1:2203 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1109
Practice Address - Country:US
Practice Address - Phone:443-253-0972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker