Individual
MOHAMED KOMKANDA BANGURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
702 15TH ST NE, WASHINGTON, DC 20002-4508
(202) 847-3218
Mailing address
702 15TH ST NE, WASHINGTON, DC 20002-4508
(202) 847-3218
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/11/2023
Last updated
05/12/2023
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