Provider Demographics
NPI:1548743644
Name:BEBOH, VANESSA (HHA)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:BEBOH
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 ANDREW CT APT 101
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2338
Mailing Address - Country:US
Mailing Address - Phone:240-533-1166
Mailing Address - Fax:
Practice Address - Street 1:3457 ANDREW CT APT 101
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2338
Practice Address - Country:US
Practice Address - Phone:240-533-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13956374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide