Healthcare Provider Details

I. General information

NPI: 1124720594
Provider Name (Legal Business Name): ZIPPORAH NYOH ENOH LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 WHITMER DR APT 12
WOODBRIDGE VA
22193-2925
US

IV. Provider business mailing address

2604 BLUHAVEN CT
SILVER SPRING MD
20906-3116
US

V. Phone/Fax

Practice location:
  • Phone: 301-675-1864
  • Fax:
Mailing address:
  • Phone: 301-675-1864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200004454
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: