Individual
CLINTON EGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6200 WESTCHESTER PARK DR APT 520, COLLEGE PARK, MD 20740-2837
(240) 714-0295
Mailing address
6200 WESTCHESTER PARK DR APT 520, COLLEGE PARK, MD 20740-2837
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/29/2022
Last updated
07/28/2025
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