Individual
BASILE CHUNSONGE MUKONGCHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 12TH ST SE STE G35, WASHINGTON, DC 20003-3738
(202) 544-8090
(202) 544-8091
Mailing address
1818 24TH ST NE, WASHINGTON, DC 20002-1934
(202) 344-7171
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13874
DC
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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