Individual
MUSONG TITA MACKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
95 CAPITAL CT, UPPER MARLBORO, MD 20774-1088
(240) 498-2067
Mailing address
95 CAPITAL CT, UPPER MARLBORO, MD 20774-1088
(240) 498-2067
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
12/08/2025
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