Provider Demographics
NPI:1558086496
Name:MUNOH MBAH, PRICILIA FRI
Entity Type:Individual
Prefix:
First Name:PRICILIA
Middle Name:FRI
Last Name:MUNOH MBAH
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 1:403 COLLEGE PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1127
Mailing Address - Country:US
Mailing Address - Phone:301-728-7814
Mailing Address - Fax:
Practice Address - Street 1:403 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1127
Practice Address - Country:US
Practice Address - Phone:301-728-7814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator