MEDICARE: YOLANDE MARIANIQUE KUTO

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	374U00000X	Home Health Aide	HHA12850	DC

General Provider Information

NPI Number	:	1780102988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDE MARIANIQUE KUTO

Provider Business Mailing Address
First Line	:	7905 KREEGER DR APT 104
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-6453
Country	:	US
Telephone Number	:	301-917-5645
Fax Number	:

Provider Business Practice Location Address
First Line	:	7905 KREEGER DR APT 104
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-6453
Country	:	US
Telephone Number	:	301-917-5645
Fax Number	:

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

Provider Enumeration Date	:	09/07/2017
Last Update Date	:	07/21/2022

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