Healthcare Provider Details

I. General information

NPI: 1194522474
Provider Name (Legal Business Name): THERESIA ATUH ACHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 03/22/2025
Certification Date: 03/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 85TH AVE APT 1
LANHAM MD
20706-4512
US

IV. Provider business mailing address

5421 85TH AVE APT 1
LANHAM MD
20706-4512
US

V. Phone/Fax

Practice location:
  • Phone: 240-413-5678
  • Fax:
Mailing address:
  • Phone: 240-413-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number200004427
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: