Healthcare Provider Details

I. General information

NPI: 1942904172
Provider Name (Legal Business Name): BRENDA MBAH AGBORGOH ACHIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1427 GOOD HOPE RD SE
WASHINGTON DC
20020-5614
US

IV. Provider business mailing address

1427 MARION BARRY AVE SE
WASHINGTON DC
20020-5614
US

V. Phone/Fax

Practice location:
  • Phone: 202-836-4841
  • Fax:
Mailing address:
  • Phone: 202-836-4841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200004459
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: