MEDICARE: MS. ADJELEY AMENG OSEKRE MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	09852	MD
2	104100000X	Social Worker	LC302971	DC

General Provider Information

NPI Number	:	1053594440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADJELEY AMENG OSEKRE MSW

Provider Business Mailing Address
First Line	:	4008 12TH STREET NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017
Country	:	US
Telephone Number	:	202-309-5215
Fax Number	:

Provider Business Practice Location Address
First Line	:	4008 12TH STREET NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017
Country	:	US
Telephone Number	:	202-309-5215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2007
Last Update Date	:	12/10/2007

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