Individual
MISS MIRABEL NDI AMBANG I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3405 DODGE PARK RD APT 201, HYATTSVILLE, MD 20785-2013
(202) 702-6423
Mailing address
3405 DODGE PARK RD APT 201, HYATTSVILLE, MD 20785-2013
(202) 702-6423
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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