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BONGEAHFONGE PATRICIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5626 WHITFIELD CHAPEL RD LANHAM, LANHAM, MD 20706
(202) 910-9212
Mailing address
5626 WHITFIELD CHAPEL RD LANHAM, LANHAM, MD 20706

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12525
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41302698
DC
Enumeration date
01/24/2017
Last updated
02/16/2017
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Product
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