Healthcare Provider Details

I. General information

NPI: 1336598234
Provider Name (Legal Business Name): LAURA KOUMTOUDJI NDUBI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 L ST NW STE 900
WASHINGTON DC
20036-4208
US

IV. Provider business mailing address

1707 L ST NW STE 900
WASHINGTON DC
20036-4208
US

V. Phone/Fax

Practice location:
  • Phone: 202-829-1111
  • Fax:
Mailing address:
  • Phone: 202-829-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31020
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA12110
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: