Provider Demographics
NPI:1093417958
Name:ANGANA METONGO, DOROTHEE MICHELE (COTA)
Entity Type:Individual
Prefix:
First Name:DOROTHEE
Middle Name:MICHELE
Last Name:ANGANA METONGO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 FIDLER LN APT 619
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3450
Mailing Address - Country:US
Mailing Address - Phone:908-456-0224
Mailing Address - Fax:
Practice Address - Street 1:1110 FIDLER LN APT 619
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3450
Practice Address - Country:US
Practice Address - Phone:908-456-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty