Individual
SPORA ENDAM MBANWEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 S BRAGG ST # 401, ALEXANDRIA, VA 22312-2797
(703) 814-5106
Mailing address
85 S BRAGG ST # 401, ALEXANDRIA, VA 22312-2797
(703) 814-5106
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA200003239
DC
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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