Individual
JECIKA ENYOH TIBAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 HERRINGTON DR, UPPER MARLBORO, MD 20774-1511
(240) 487-8245
Mailing address
303 HERRINGTON DR, UPPER MARLBORO, MD 20774-1511
(240) 487-8245
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
163W00000X
Registered Nurse
Primary
RN500125701
DC
Other
Enumeration date
09/03/2021
Last updated
07/07/2025
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