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NPI Code Detail

MEDICARE: MS. MELANIE MENGUE MBALLA

MEDICARE:  MS. MELANIE MENGUE MBALLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideDC

General Provider Information

NPI Number : 1205418902
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELANIE MENGUE MBALLA
Provider Business Mailing Address
First Line : 9502 WASHINGTON BLVD # 20706
Second Line :
City : LANHAM
State : MD
Zip : 20706-4031
Country : US
Telephone Number : 301-256-6774
Fax Number :
Provider Business Practice Location Address
First Line : 9502 WASHINGTON BLVD APT 202
Second Line :
City : LANHAM
State : MD
Zip : 20706-4031
Country : US
Telephone Number : 301-256-6774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2021
Last Update Date : 04/22/2021

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Directions to “ MS. MELANIE MENGUE MBALLA ” Practice Location

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