Individual
LAURELLE KONGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
908 ATLEE DR, HYATTSVILLE, MD 20785-5959
(240) 828-0131
Mailing address
908 ATLEE DR, HYATTSVILLE, MD 20785-5959
(240) 828-0131
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA15487
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA15487
—
DC
Enumeration date
12/09/2020
Last updated
12/09/2020
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