Individual
MS. MAMBO AWAHMUKALAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10507 WHARFDALE PL, GAINESVILLE, VA 20155-4871
(571) 261-0100
Mailing address
10507 WHARFDALE PL, GAINESVILLE, VA 20155-4871
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
0001267803
VA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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