Individual
MARIE BERTHE MADZE FOTSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
9202 CENTER OAK CT, MECHANICSVILLE, VA 23116-2744
(804) 207-6737
Mailing address
6501 N CHARLES ST, TOWSON, MD 21204-6819
(410) 938-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024191751
VA
Other
Enumeration date
11/08/2024
Last updated
12/16/2024
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