Individual
LISSETTE MUKE FONGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2306 BRIGHTSEAT RD APT 5, HYATTSVILLE, MD 20785-3550
(202) 758-4209
Mailing address
2306 BRIGHTSEAT RD APT 5, HYATTSVILLE, MD 20785-3550
(202) 758-4209
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
05/08/2018
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