Individual
ETIENDEM RAY EBESOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2807 ORCHARD SUMMIT CT, HYATTSVILLE, MD 20785-2621
(240) 615-1072
Mailing address
2807 ORCHARD SUMMIT CT, HYATTSVILLE, MD 20785-2621
(240) 615-1072
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
374U00000X
Home Health Aide
Primary
—
DC
Other
Enumeration date
11/10/2025
Last updated
12/03/2025
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