Provider Demographics
NPI:1376237248
Name:KYUNGU KABANGE, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KYUNGU KABANGE
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 1:3700 9TH ST SE APT 1021
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4038
Mailing Address - Country:US
Mailing Address - Phone:845-233-8094
Mailing Address - Fax:
Practice Address - Street 1:2526 PENNSYLVANIA AVE SE STE C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6729
Practice Address - Country:US
Practice Address - Phone:202-748-5641
Practice Address - Fax:202-748-5647
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator