MEDICARE: MABEL QUEEN SESAY

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
1	374U00000X	Home Health Aide		VA

General Provider Information

NPI Number	:	1922817410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MABEL QUEEN SESAY

Provider Business Mailing Address
First Line	:	16801 CAPON TREE LN
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-5134
Country	:	US
Telephone Number	:	703-865-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	16801 CAPON TREE LN
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-5134
Country	:	US
Telephone Number	:	703-865-9191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2024
Last Update Date	:	12/31/2024

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Directions to “ MABEL QUEEN SESAY ” Practice Location

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