Individual
JECINTA N EMENAYOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6351 64TH AVE APT 1, RIVERDALE, MD 20737-1519
(240) 706-1421
Mailing address
6351 64TH AVE APT 1, RIVERDALE, MD 20737-1519
(240) 706-1421
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A00179695
—
MD
Enumeration date
09/08/2020
Last updated
09/08/2020
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