Individual
MR. DERICK AMIN ATABONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HHA
Contact information
Practice address
13125 LARCHDALE RD, APT 7, LAUREL, MD 20708
(240) 646-4085
Mailing address
13125 LARCHDALE RD, APT 7, LAUREL, MD 20708
(240) 646-4085
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
4645
DC
376K00000X
Nurse's Aide
4645
DC
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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