Individual
MIVIAN ACHA FONJAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5307 85TH AVE APT 11, NEW CARROLLTON, MD 20784-3228
(781) 268-1081
Mailing address
5307 85TH AVE APT 11, NEW CARROLLTON, MD 20784-3228
(781) 268-1081
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA200004823
DC
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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