Individual
DR. CHEEDY JAJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, MSN, PMHNP-BC
Contact information
Practice address
COLLEGE OF NURSING 1601 GREENE STREET, COLUMBIA, SC 29208-0001
(803) 777-0472
Mailing address
2038 LAKE MURRAY BLVD APT 11303, COLUMBIA, SC 29212-0851
(941) 210-2508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22293A
SC
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
222993
SC
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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