Individual
KELLY FONJUNGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 TAYLOR ST NW, WASHINGTON, DC 20011-5617
(202) 464-9200
Mailing address
14727 4TH ST UNIT 447, LAUREL, MD 20707-3994
(443) 946-0645
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
10/02/2023
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