Provider Demographics
NPI:1073856381
Name:METTU, HELEN EZINNE
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:EZINNE
Last Name:METTU
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 1:6935 LAUREL AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6935 LAUREL AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4413
Practice Address - Country:US
Practice Address - Phone:301-270-1577
Practice Address - Fax:301-270-1588
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide