Provider Demographics
NPI:1407100605
Name:TCHOUAMO DJOUMALE, GISELINE (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:MS
First Name:GISELINE
Middle Name:
Last Name:TCHOUAMO DJOUMALE
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 MANCHESTER RD
Mailing Address - Street 2:APT 2
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4116
Mailing Address - Country:US
Mailing Address - Phone:240-423-1331
Mailing Address - Fax:
Practice Address - Street 1:8800 MANCHESTER RD
Practice Address - Street 2:APT 2
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4116
Practice Address - Country:US
Practice Address - Phone:240-423-1331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide