Provider Demographics
NPI:1194076950
Name:ANYE, DIVINE (HHA)
Entity type:Individual
Prefix:
First Name:DIVINE
Middle Name:
Last Name:ANYE
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6436 BRIGHTLEA DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2850
Mailing Address - Country:US
Mailing Address - Phone:202-292-7700
Mailing Address - Fax:
Practice Address - Street 1:6436 BRIGHTLEA DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2850
Practice Address - Country:US
Practice Address - Phone:202-292-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker