Individual
MARIE TRESOR MAKOUTSING NZONGOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6495 NEW HAMPSHIRE AVE, HYATTSVILLE, MD 20783-3245
(240) 825-3153
Mailing address
8106 MARTIN LUTHER KING JR HWY, LANHAM, MD 20706-1554
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00113380
MD
Other
Enumeration date
11/02/2020
Last updated
12/16/2020
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