Healthcare Provider Details

I. General information

NPI: 1063268274
Provider Name (Legal Business Name): MISS MICHELLE ZOKOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 15TH ST NE
WASHINGTON DC
20002-4508
US

IV. Provider business mailing address

11700 OLD COLUMBIA PIKE APT 907
SILVER SPRING MD
20904-2554
US

V. Phone/Fax

Practice location:
  • Phone: 202-388-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: