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Individual

CONCILIA DABA ENJEH MARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5309 RIVERDALE RD APT 402, RIVERDALE, MD 20737-2232
(240) 495-4908
Mailing address
5309 RIVERDALE RD APT 402, RIVERDALE, MD 20737-2232
(301) 792-0783

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA14380
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HHA14380
DC
Enumeration date
04/16/2019
Last updated
04/16/2019
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