Individual
MRS. ELIZABETH BONGHOR BANGURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 GABLERIDGE TURN, WOODBRIDGE, VA 22191-1972
(703) 899-9642
Mailing address
3108 PS BUSINESS CENTER DR, WOODBRIDGE, VA 22192-4258
(571) 552-3509
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
A00165718
MD
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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