Individual
DORA YEBOAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4834 AUTUMN GLORY WAY, CHANTILLY, VA 20151-2352
(703) 263-0861
(703) 968-9293
Mailing address
4834 AUTUMN GLORY WAY, CHANTILLY, VA 20151-2352
(703) 263-0861
(703) 968-3942
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629339700
—
VA
Enumeration date
05/06/2022
Last updated
06/30/2022
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