Healthcare Provider Details

I. General information

NPI: 1518897941
Provider Name (Legal Business Name): T-MAMOUNE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 CARRIAGE HILL CIR APT 203
RANDALLSTOWN MD
21133-3026
US

IV. Provider business mailing address

3424 CARRIAGE HILL CIR APT 203
RANDALLSTOWN MD
21133-3026
US

V. Phone/Fax

Practice location:
  • Phone: 240-814-4660
  • Fax:
Mailing address:
  • Phone: 240-814-4660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: STHONCA NEILAH JOANISSE
Title or Position: CEO
Credential:
Phone: 240-814-4660