Individual
COLETTE ACHE TEBONG-HOSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 MARTIN BLVD, MIDDLE RIVER, MD 21220-4103
(410) 870-4983
Mailing address
7814 LOBLOLLY WAY, HANOVER, MD 21076-2180
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
R162723
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R162723
MD
Other
Enumeration date
12/09/2021
Last updated
01/16/2023
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