Individual
MR. CLIFFORD WAKHA KIBANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HHA
Contact information
Practice address
3271 QUEENSTOWN DRIVE, APT #201, MOUNT RAINIER, MD 20712
(240) 413-1428
Mailing address
3271 QUEENSTOWN DR APT 201, MOUNT RAINIER, MD 20712-1082
(240) 413-1428
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13011
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA13011
DC BOARD OF NURSING
DC
05
—
HHA13011
—
DC
Enumeration date
08/21/2017
Last updated
07/21/2022
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