Healthcare Provider Details

I. General information

NPI: 1518859081
Provider Name (Legal Business Name): HUSSAINATU JALLOH BSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 BLADENSBURG RD NE
WASHINGTON DC
20018-1425
US

IV. Provider business mailing address

8800 ENFIELD CT APT 12
LAUREL MD
20708-2051
US

V. Phone/Fax

Practice location:
  • Phone: 202-255-2574
  • Fax:
Mailing address:
  • Phone: 614-556-0257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: