Individual
JEMINAT BOSE MOMODU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4740 EASTERN AVE NE, WASHINGTON, DC 20017-3127
(240) 795-8932
Mailing address
4740 EASTERN AVE NE, WASHINGTON, DC 20017-3127
(240) 795-8932
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HHA200003601
DC
374U00000X
Home Health Aide
Primary
HHA200003601
DC
Other
Enumeration date
03/20/2024
Last updated
03/26/2024
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