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Individual

ACHIANU DIVINE FOLEFAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9470 ANNAPOLIS RD, LANHAM, MD 20706-3025
(202) 499-4300
Mailing address
14410 STEPPING STONE WAY, BURTONSVILLE, MD 20866-1937
(240) 355-9619

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R212231
MD

Other

Enumeration date
03/25/2022
Last updated
03/25/2022
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