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Individual
ROSINE KELLY KOUEBOU MBOUKEM
Active
Individual
ROSINE KELLY KOUEBOU MBOUKEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13767
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA13767
HHA LICENSE NUMBER
DC
01
—
K-151-744-019-067
DRIVER LICENSE
MD
Enumeration date
06/22/2018
Last updated
06/22/2018
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