Individual
MISS MBALU WATAH FOFANAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
2811 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-3865
(202) 894-6811
Mailing address
9000 MANCHESTER RD APT 22, SILVER SPRING, MD 20901-4124
(240) 486-4237
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
03/08/2023
Last updated
09/12/2023
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