Provider Demographics
NPI:1033744982
Name:NGO MPONDI MBOCK, MARIE FLORENCE
Entity Type:Individual
Prefix:
First Name:MARIE FLORENCE
Middle Name:
Last Name:NGO MPONDI MBOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3649 ELDER OAKS BLVD APT 2405
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-7306
Mailing Address - Country:US
Mailing Address - Phone:240-467-1679
Mailing Address - Fax:
Practice Address - Street 1:1845 HARVARD ST NW APT 709
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2385
Practice Address - Country:US
Practice Address - Phone:202-797-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant