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General NPI Number Information
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NPI Number | 1780240168
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Entity Type | Individual
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Provider Name | TAMBA KONDEH
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Gender | Male
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Dates
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Enumeration Date | 05/11/2019
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Last Update Date | 05/11/2019
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Provider Practice Location Address
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Address Line | 59 V ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-1012
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Country | US
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Telephone | 240-906-7496
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Fax |
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Provider Business Mailing Address
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Address Line | 5218 MARIES RETREAT DR
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City | BOWIE
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State | MD
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Zip | 20720-3344
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Country | US
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Telephone | 240-760-8262
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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