Individual
MS. FANTA FOFANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9729 GOOD LUCK RD APT 3, LANHAM, MD 20706-3314
(240) 354-1538
Mailing address
9729 GOOD LUCK RD APT 3, LANHAM, MD 20706-3314
(240) 354-1538
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA10231
DC
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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