Healthcare Provider Details

I. General information

NPI: 1447116496
Provider Name (Legal Business Name): MARIE LOUISE KAADJOUO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11705 MONTAGUE DR
LAUREL MD
20708-2815
US

IV. Provider business mailing address

11705 MONTAGUE DR
LAUREL MD
20708-2815
US

V. Phone/Fax

Practice location:
  • Phone: 240-713-7427
  • Fax:
Mailing address:
  • Phone: 240-713-7427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200005927
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: