Healthcare Provider Details

I. General information

NPI: 1477234433
Provider Name (Legal Business Name): FNU DELPHINE NTOMNE NTOH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 ANDREW CT APT 203
LAUREL MD
20724-2334
US

IV. Provider business mailing address

650 PENNSYLVANIA AVE SE STE 330
WASHINGTON DC
20003-4397
US

V. Phone/Fax

Practice location:
  • Phone: 757-324-9656
  • Fax:
Mailing address:
  • Phone: 202-864-4184
  • Fax: 202-864-4158

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 Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: