Individual
DIVINE KIMAH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7837 RIVERDALE RD, APT 302, NEW CARROLLTON, MD 20784-4020
(240) 264-9850
Mailing address
7837 RIVERDALE RD, APT 302, NEW CARROLLTON, MD 20784-4020
(240) 264-9850
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA10240
DC
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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