Individual
BERNICE BONGO I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5504 SMITA PL LANHAM, LANHAM, MD 20706
(240) 598-8118
Mailing address
5504 SMITA PL LANHAM, LANHAM, MD 20706
(202) 948-5255
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
374U00000X
Home Health Aide
HHA200005239
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/07/2024
Last updated
08/13/2025
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