Individual
JOEL FONGANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2010 RHODE ISLAND AVE NE, WASHINGTON, DC 20018-2835
(202) 526-3535
Mailing address
3801 KENILWORTH AVE APT 302E, BLADENSBURG, MD 20710-2131
(202) 679-7710
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
HHA14451
DC
Other
Enumeration date
05/14/2019
Last updated
07/25/2023
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