Individual
KOSSIVI IVLABUE KENOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6209 WESTBROOK DR, NEW CARROLLTON, MD 20784-3512
(240) 423-9341
(240) 423-9341
Mailing address
6209 WESTBROOK DR, NEW CARROLLTON, MD 20784-3512
(240) 423-9341
(240) 423-9341
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA200004673
DC
Other
Enumeration date
03/08/2025
Last updated
03/08/2025
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