Most Relevant Information
Provider Data
| NPI Number: | 1003640582 |
| Provider Name: | MIREILLE MBOUMBOU |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/28/2024 |
| Last Updated: | 08/28/2024 |
Provider Practice Location
1131 UNIVERSITY BLVD W APT 820
SILVER SPRING
MD
209023309
Practice Location Phone/Fax
| Phone: | 2025346886 |
| Fax: |
Provider Mailing Location
1131 UNIVERSITY BLVD W APT 820
SILVER SPRING
MD
209023309
Provider Mailing Phone/Fax
| Phone: | 2025346886 |
| Fax: |