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General NPI Number Information
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NPI Number | 1508657750
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Entity Type | Individual
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Provider Name | MARCELA C MWANDU
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Gender | Female
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1500 WESTBRANCH DR APT 3101500
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City | MC LEAN
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State | VA
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Zip | 22102-3269
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Country | US
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Telephone | 240-435-9522
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Fax | 240-435-9522
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Provider Business Mailing Address
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Address Line | 1500 WESTBRANCH DR APT 3101500
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City | MC LEAN
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State | VA
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Zip | 22102-3269
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Country | US
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Telephone | 240-435-9522
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Fax | 240-435-9522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP56980
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License Number State | MD
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