Individual
DIVINE JIMLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASE MANAGER
Contact information
Practice address
6428 LANDING WAY, HYATTSVILLE, MD 20784-4619
(301) 442-1801
Mailing address
6428 LANDING WAY, HYATTSVILLE, MD 20784-4619
(301) 442-1801
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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