Individual
EKU JAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHA
Contact information
Practice address
14807 BOWIE RD APT 201, LAUREL, MD 20708-1040
(202) 545-0935
(202) 545-0934
Mailing address
14807 BOWIE RD APT 201, LAUREL, MD 20708-1040
(202) 545-0935
(202) 545-0934
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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