Individual
CACILIA FONKEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11700 OLD COLUMBIA PIKE APT 2105, SILVER SPRING, MD 20904-2559
(914) 299-2812
Mailing address
11700 OLD COLUMBIA PIKE APT 2105, SILVER SPRING, MD 20904-2559
(914) 299-2812
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/09/2013
Last updated
06/22/2023
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