Individual
JACQUELINE IDA DJOMOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 LOCKWOOD DR, SILVER SPRING, MD 20901-4551
(240) 938-0314
Mailing address
11200 LOCKWOOD DR, SILVER SPRING, MD 20901-4551
(240) 938-0314
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
HHA200002704
DC
Other
Enumeration date
06/01/2023
Last updated
07/19/2023
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