Provider Demographics
NPI:1366904542
Name:SAWO, JAHZUYAN M
Entity type:Individual
Prefix:MR
First Name:JAHZUYAN
Middle Name:M
Last Name:SAWO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 PEACHTREE RD APT G
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2286
Mailing Address - Country:US
Mailing Address - Phone:302-388-3537
Mailing Address - Fax:
Practice Address - Street 1:804 PEACHTREE RD APT G
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2286
Practice Address - Country:US
Practice Address - Phone:302-388-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1447535422OtherI DO NOT HAVE MEDICAID