Individual
LACKALONG NDIKUM NDIFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8627 ANNAPOLIS RD, NEW CARROLLTON, MD 20784-3108
(302) 423-4568
Mailing address
8627 ANNAPOLIS RD, NEW CARROLLTON, MD 20784-3108
(302) 423-4568
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
374U00000X
Home Health Aide
HHA13240
DC
Other
Enumeration date
12/01/2017
Last updated
09/25/2023
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