Individual
CLOVIS FONTEBO AZAAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6823A RIVERDALE RD APT A2, RIVERDALE, MD 20737-1838
(240) 487-8425
Mailing address
6823A RIVERDALE RD APT A2, RIVERDALE, MD 20737-1838
(240) 487-8425
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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