Provider Demographics
NPI:1790577716
Name:BEDELL, NYEMALAY
Entity type:Individual
Prefix:
First Name:NYEMALAY
Middle Name:
Last Name:BEDELL
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 1:1419 FARMCREST WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-6027
Mailing Address - Country:US
Mailing Address - Phone:240-474-6612
Mailing Address - Fax:
Practice Address - Street 1:14900 SWEITZER LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-2915
Practice Address - Country:US
Practice Address - Phone:301-615-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician