Provider Demographics
NPI:1932916822
Name:GASKINS, KISHA M
Entity type:Individual
Prefix:
First Name:KISHA
Middle Name:M
Last Name:GASKINS
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 1:4221 FORBES BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4820
Mailing Address - Country:US
Mailing Address - Phone:443-252-3856
Mailing Address - Fax:
Practice Address - Street 1:4221 FORBES BLVD STE 220
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4820
Practice Address - Country:US
Practice Address - Phone:443-252-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health