Individual
SHELLEY KENNETH MBANWEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-2408
(202) 878-6626
Mailing address
7702 QUAINT CT, BOWIE, MD 20720-4316
(202) 629-8674
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
140636
DC
Other
Enumeration date
05/30/2012
Last updated
12/06/2023
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