Provider Demographics
NPI:1508621855
Name:AGBOR, ANNE MARIE AYUK TAKOH
Entity Type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:AYUK TAKOH
Last Name:AGBOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AYUK TAKOH
Other - Middle Name:
Other - Last Name:AGBOR ANNE MARIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 KYLE CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3620
Mailing Address - Country:US
Mailing Address - Phone:240-971-6394
Mailing Address - Fax:
Practice Address - Street 1:2811 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3865
Practice Address - Country:US
Practice Address - Phone:202-894-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator