Individual
ODETTE MOKUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
709 HUDSON AVE APT 3, TAKOMA PARK, MD 20912-6817
(240) 486-7333
Mailing address
709 HUDSON AVE APT 3, TAKOMA PARK, MD 20912-6817
(240) 486-7333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
VA
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
376K00000X
Nurse's Aide
Primary
1401191138
VA
376K00000X
Nurse's Aide
—
VA
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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