Individual
ELVINE C KENSONG TIBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1533 HUNTER RD, FAIRFIELD, OH 45014-4609
(301) 331-8498
Mailing address
1533 HUNTER RD, FAIRFIELD, OH 45014-4609
(301) 331-8498
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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