Individual
BEATRICE BOUOMGNY EPSE MWANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 DATELEAF AVE, CAPITOL HEIGHTS, MD 20743-6005
(301) 675-6192
Mailing address
510 DATELEAF AVE, CAPITOL HEIGHTS, MD 20743-6005
(301) 675-6192
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CNA20203546
—
MD
Enumeration date
02/25/2021
Last updated
02/25/2021
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