Individual
ETHYLIEN NDUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 BRYAN PL SE, WASHINGTON, DC 20020-4417
(202) 894-6811
Mailing address
5078 SILVER HILL CT APT 104, FORESTVILLE, MD 20747-2029
(240) 486-7460
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
374U00000X
Home Health Aide
HHA15705
DC
Other
Enumeration date
03/22/2022
Last updated
06/27/2023
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