Provider Demographics
NPI:1871096982
Name:AITKINS, TEDRINA N
Entity type:Individual
Prefix:
First Name:TEDRINA
Middle Name:N
Last Name:AITKINS
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 1:10311 STORCH DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2179
Mailing Address - Country:US
Mailing Address - Phone:240-694-7198
Mailing Address - Fax:
Practice Address - Street 1:10311 STORCH DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2179
Practice Address - Country:US
Practice Address - Phone:240-694-7198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical