Provider Demographics
NPI:1376314898
Name:ELUMBU, DORCAS BOMBINDO (HIGH SCHOOL DIPLOMA)
Entity Type:Individual
Prefix:MS
First Name:DORCAS
Middle Name:BOMBINDO
Last Name:ELUMBU
Suffix:
Gender:F
Credentials:HIGH SCHOOL DIPLOMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6313 64TH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1507
Mailing Address - Country:US
Mailing Address - Phone:240-758-5475
Mailing Address - Fax:
Practice Address - Street 1:6313 64TH AVE APT 6
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1507
Practice Address - Country:US
Practice Address - Phone:240-758-5475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator