Individual
MISPA AZIWUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6426 TIFFANY CT, LANHAM, MD 20706-3541
(240) 722-9884
Mailing address
6426 TIFFANY CT, LANHAM, MD 20706-3541
(240) 722-9884
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA0000812767
—
DC
Enumeration date
01/21/2021
Last updated
01/21/2021
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