Individual
KELLY SIRRI FOBANJONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5601 13TH ST NW APT 208, WASHINGTON, DC 20011-3562
(774) 417-8317
Mailing address
5601 13TH ST NW APT 208, WASHINGTON, DC 20011
(774) 417-8317
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/13/2015
Last updated
05/12/2025
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