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Individual

BOSASA AYAMBA MIRIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6305 IVY LN STE 610, GREENBELT, MD 20770-6363
(202) 790-8903
(301) 889-9735
Mailing address
6305 IVY LN STE 610, GREENBELT, MD 20770-6363
(202) 790-8903
(301) 889-9735

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-22-200229
MD
374U00000X
Home Health Aide
Primary
HHA11692
DC

Other

Enumeration date
03/11/2016
Last updated
05/26/2023
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