Individual
AUSTIN WIDJAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20410 OBSERVATION DR STE 108, GERMANTOWN, MD 20876-6419
(240) 296-6037
Mailing address
18420 KINGSHILL RD, GERMANTOWN, MD 20874-2210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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