Individual
AMIDA IDRISSOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHA
Contact information
Practice address
7600 MAPLE AVE APT 510, TAKOMA PARK, MD 20912-5543
(202) 910-7928
Mailing address
7600 MAPLE AVE APT 510, TAKOMA PARK, MD 20912-5543
(202) 910-7928
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12427
DC
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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