Individual
FANTA BOMPORO KOROMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9522 MUIRKIRK RD APT 301, LAUREL, MD 20708-2736
(240) 485-7735
Mailing address
9522 MUIRKIRK RD APT 301, LAUREL, MD 20708-2736
(240) 485-7735
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
Primary
HHA200005664
DC
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
02/07/2021
Last updated
12/08/2025
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