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Individual

LARISSA MEGOUJOU FOSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7777 MAPLE AVE APT 1211, TAKOMA PARK, MD 20912-5650
(202) 763-2653
Mailing address
7777 MAPLE AVE APT 1211, TAKOMA PARK, MD 20912-5650
(202) 763-2653

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M221488018967
MULTIPLAN
MD
Enumeration date
12/03/2013
Last updated
03/01/2018
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