Individual
TENTEU GERVAIS SOUOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4660 MARTIN LUTHER KING JR AVE SW STE A3, WASHINGTON, DC 20032-4958
(202) 318-0179
Mailing address
6841 RIVERDALE RD, APT 201C, RIVERDALE, MD 20737
(301) 256-5009
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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