Individual
MBUH SOPPO ELISABETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3215 75TH AVE, HYATTSVILLE, MD 20785-1923
(614) 316-4118
Mailing address
3215 75TH AVE, HYATTSVILLE, MD 20785-1923
(614) 316-4118
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13613
DC
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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