Individual
DANEISHA FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4209 28TH AVE APT 203, TEMPLE HILLS, MD 20748-1731
(252) 412-2344
Mailing address
4209 28TH AVE APT 203, TEMPLE HILLS, MD 20748-1731
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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