Individual
ANDY KOUACOU-KLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7211 PARK HEIGHTS AVE STE 4, BALTIMORE, MD 21208-5497
(240) 486-0357
Mailing address
1921 BEECHAM CT, BOWIE, MD 20721-2705
(240) 988-0116
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/04/2025
Last updated
07/04/2025
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