Individual
BIANCA MOUKOURI KOUOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9440 MARLBORO PIKE, STE 100, UPPER MARLBORO, MD 20772
(240) 392-2643
Mailing address
3302 ALTAIR LN, UPPER MARLBORO, MD 20774-3550
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49301421600
—
MD
Enumeration date
06/09/2022
Last updated
06/09/2022
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