Provider Demographics
NPI:1417733213
Name:TCHANTCHO, HELDRINE POWOH MEGYENTOH
Entity Type:Individual
Prefix:
First Name:HELDRINE
Middle Name:POWOH MEGYENTOH
Last Name:TCHANTCHO
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 1:15808 PILLER LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1444
Mailing Address - Country:US
Mailing Address - Phone:120-220-9591
Mailing Address - Fax:
Practice Address - Street 1:15808 PILLER LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1444
Practice Address - Country:US
Practice Address - Phone:120-220-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator