Provider Demographics
NPI:1639330442
Name:BEBNJI-NGUH, REGINA NDONGBOH
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:NDONGBOH
Last Name:BEBNJI-NGUH
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 1:1810 SAHARA LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2736
Mailing Address - Country:US
Mailing Address - Phone:301-333-1238
Mailing Address - Fax:
Practice Address - Street 1:1330 7TH ST NW
Practice Address - Street 2:APT. # 905
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3565
Practice Address - Country:US
Practice Address - Phone:240-463-2324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities