Healthcare Provider Details

I. General information

NPI: 1780062182
Provider Name (Legal Business Name): TCHOUA JULIENNE NJABBOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 18TH ST NE
WASHINGTON DC
20018-2738
US

IV. Provider business mailing address

3500 18TH ST NE
WASHINGTON DC
20018-2738
US

V. Phone/Fax

Practice location:
  • Phone: 202-529-6510
  • Fax: 202-529-6570
Mailing address:
  • Phone: 202-529-6510
  • Fax: 202-529-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA11251
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: