Individual
SIDOLINE NKEGOU ATABONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6127 64TH AVE APT 5, RIVERDALE, MD 20737-2936
(240) 714-1802
Mailing address
6127 64TH AVE APT 5, RIVERDALE, MD 20737-2936
(240) 714-1802
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
HHA12316
DC
Other
Enumeration date
08/29/2016
Last updated
07/19/2023
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