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Individual

ADE ELEHANAH TAYIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1203 REDCRESTED CT, UPPER MARLBORO, MD 20774-7081
(301) 683-4579
Mailing address
1203 REDCRESTED CT, UPPER MARLBORO, MD 20774-7081
(301) 683-4579

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
374U00000X
Home Health Aide
HHA12952
WA

Other

Enumeration date
08/03/2017
Last updated
01/18/2024
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