Individual
JEPHTE NOUTSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9223 FAIRLANE PL, LAUREL, MD 20708-2862
(301) 792-8652
Mailing address
9223 FAIRLANE PL, LAUREL, MD 20708-2862
(301) 792-8652
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
DC
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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