Individual
CHARLY BERNARD NDJAKOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1713 TROTTER ST, FREDERICK, MD 21702-2379
(240) 315-9659
Mailing address
1713 TROTTER ST, FREDERICK, MD 21702-2379
(240) 315-9659
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1180921
MD
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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