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Individual

MR. ANTONY OTIENO ODHIAMBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1606 UNIVERSITY BLVD W, SILVER SPRING, MD 20902-3649
(240) 815-3480
Mailing address
1606 UNIVERSITY BLVD W, SILVER SPRING, MD 20902-3649
(240) 815-3480

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MD
374U00000X
Home Health Aide
Primary
HHA13021
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0351067668254
DRIVE'S LICENSE NO
MD
Enumeration date
09/07/2017
Last updated
02/04/2026
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