Individual
FONGWI GLADYS EPSE TAH N JONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6856 EASTERN NW, #376, WASHINGTON, DC 20012
(240) 714-6289
Mailing address
6856 EASTERN NW, #376, WASHINGTON, DC 20012
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12249
DC
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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