Organization
KATEGODWIN MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM EZENWAKA MSN, CRNP (OWNER)
(301) 675-5364
Entity
Organization
Contact information
Practice address
18941 HIGHSTREAM DR, GERMANTOWN, MD 20874-6169
(301) 675-5364
Mailing address
4106 WINDING WATERS TER, UPPER MARLBORO, MD 20772-2504
(301) 675-5364
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
12/04/2024
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