Individual
EDWIN AMBE AMABO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10712 MARIETTA ST, GLENN DALE, MD 20769-9405
(301) 701-0222
Mailing address
10712 MARIETTA ST, GLENN DALE, MD 20769-9405
(301) 701-0222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
06/17/2025
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