Individual
MARY SHAYE KONGNYUY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3430 DODGE PACK ROAD, HYATTSVILLE, MD 20785
(202) 766-6408
Mailing address
3430 DODGE PACK ROAD, HYATTSVILLE, MD 20785
(202) 766-6408
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13058
DC
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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