Provider Demographics
NPI:1710234927
Name:NGOLLO, MARIE (HHOME HEALTH AIDE)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:NGOLLO
Suffix:
Gender:F
Credentials:HHOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9905 GOOD LUCK RD
Mailing Address - Street 2:APT # 101
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3246
Mailing Address - Country:US
Mailing Address - Phone:301-794-7363
Mailing Address - Fax:
Practice Address - Street 1:9905 GOOD LUCK RD
Practice Address - Street 2:APT # 101
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3246
Practice Address - Country:US
Practice Address - Phone:301-794-7363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide