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General NPI Number Information
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NPI Number | 1811858251
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Entity Type | Individual
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Provider Name | LUCIENNE DJOUBA BONDIMA
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 4909 OLD COURT RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4628
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Country | US
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Telephone | 443-278-3227
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Fax |
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Provider Business Mailing Address
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Address Line | 4909 OLD COURT RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4628
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Country | US
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Telephone | 443-278-3227
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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 | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | R214366
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License Number State | MD
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