Individual
MISPA AFOR FONGYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8012 CRADDOCK RD, GREENBELT, MD 20770-3050
(240) 854-0908
Mailing address
3801 KENILWORTH AVE APT 409W, BLADENSBURG, MD 20710-2138
(301) 458-9152
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA11010
DC
Other
Enumeration date
01/20/2015
Last updated
02/13/2024
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