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CLETUS OBI DAKIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
HHA

Contact information

Practice address
13801 CASTLE BLVD, APT 22, SILVER SPRING, MD 20904-7304
(240) 715-5590
Mailing address
13801 CASTLE BLVD, APT 22, SILVER SPRING, MD 20904-7304
(240) 715-5590

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN1005192
DC
374U00000X
Home Health Aide
Primary
HHA8995
DC

Other

Enumeration date
07/22/2013
Last updated
05/18/2016
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