Provider Demographics
NPI:1295397891
Name:AFANTENAH, SOLANGE
Entity Type:Individual
Prefix:
First Name:SOLANGE
Middle Name:
Last Name:AFANTENAH
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 1:3318 DODGE PARK RD APT 104
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2114
Mailing Address - Country:US
Mailing Address - Phone:301-851-9129
Mailing Address - Fax:
Practice Address - Street 1:3318 DODGE PARK RD APT 104
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2114
Practice Address - Country:US
Practice Address - Phone:301-851-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide