Individual
NGWE MBAKU STELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4805 LINCOLN AVE, BELTSVILLE, MD 20705-1528
(301) 529-0482
Mailing address
4805 LINCOLN AVENUE, BELTSVILLE, MD 20705
(301) 529-0482
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12689
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134956860
—
MD
Enumeration date
03/14/2017
Last updated
03/14/2017
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