Individual
AUBREVILLE AGATHON TASSOTSA NDJITSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4130 HUNT PL NE, WASHINGTON, DC 20019-3565
(202) 388-4300
Mailing address
11804 CHANTILLY LN, BOWIE, MD 20721-2131
(240) 879-7329
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
364SP0812X
Community Psychiatric/Mental Health Clinical Nurse Specialist
251B00000X
DC
Other
Enumeration date
05/03/2023
Last updated
07/05/2023
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