Individual
MARCEL THIERRY MBOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1715 NEWTON ST NE, WASHINGTON, DC 20018-2319
(202) 526-1652
Mailing address
1715 NEWTON ST NE, WASHINGTON, DC 20018-2319
(202) 526-1652
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M120585792618
—
MD
Enumeration date
07/31/2021
Last updated
06/06/2023
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