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Individual

BLANCH TANIFORM MANJOH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9505 HOBART ST, SPRINGDALE, MD 20774-5444
(901) 453-5870
Mailing address
9505 HOBART ST, SPRINGDALE, MD 20774-5444
(901) 453-5870

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
DC
374U00000X
Home Health Aide
Primary

Other

Enumeration date
01/10/2024
Last updated
03/31/2026
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