Individual
EDMOND WAINKEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3405 DODGE PARK RD APT 104, HYATTSVILLE, MD 20785-2013
(484) 326-7800
Mailing address
3405 DODGE PARK RD APT 104, HYATTSVILLE, MD 20785-2013
(484) 326-7800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/14/2023
Last updated
10/19/2023
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