Individual
CLEOPHA CHUALA TAMUFOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10009 DOLBY AVE, GLENN DALE, MD 20769-9236
(443) 742-3028
Mailing address
10009 DOLBY AVE, GLENN DALE, MD 20769-9236
(443) 742-3028
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN200002428
DC
171M00000X
Case Manager/Care Coordinator
—
DC
Other
Enumeration date
04/07/2023
Last updated
08/24/2023
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