Individual
CALISTA TETUH ENDAM EPSE UKU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5718 CYPRESS CREEK DR APT 103, HYATTSVILLE, MD 20782-1832
(240) 495-9137
Mailing address
5718 CYPRESS CREEK DR APT 103, HYATTSVILLE, MD 20782-1832
(240) 495-9137
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13249
DC
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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