Individual
GLADYS TANKOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3443 CALEDONIA CIR, WOODBRIDGE, VA 22192-1064
(571) 398-8057
Mailing address
3443 CALEDONIA CIR, WOODBRIDGE, VA 22192-1064
(571) 398-8057
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
1401165276
VA
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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