Individual
NIM FON QUEENETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1308 NORTHERN LIGHTS DR, UPPER MARLBORO, MD 20774-6033
(202) 853-4104
Mailing address
1308 NORTHERN LIGHTS DR, UPPER MARLBORO, MD 20774-6033
(202) 853-4104
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA14052
DC
Other
Enumeration date
10/26/2018
Last updated
12/05/2018
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