Individual
WILMA EVANGELINE ABUDA BANDONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDA SERVICE PROVIDER
Contact information
Practice address
3060 MITCHELLVILLE RD STE 104, BOWIE, MD 20716-3963
(202) 460-6219
Mailing address
3060 MITCHELLVILLE RD STE 104, BOWIE, MD 20716-3963
(202) 460-6219
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
MD
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9D
—
MD
Enumeration date
02/27/2018
Last updated
06/16/2018
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