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Individual

MICHELLE LARISSA MBAPOU MFABO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4332 REGALWOOD TER, BURTONSVILLE, MD 20866-2215
(240) 476-3821
Mailing address
4332 REGALWOOD TER, BURTONSVILLE, MD 20866-2215
(240) 476-3821

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202214664
VA
183500000X
Pharmacist
Primary
24089
MD

Other

Enumeration date
11/06/2016
Last updated
11/06/2016
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