Provider Demographics
NPI:1730056037
Name:KWETI, ESTHELLA ENGONWIE
Entity type:Individual
Prefix:
First Name:ESTHELLA
Middle Name:ENGONWIE
Last Name:KWETI
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 1:8828 HUNTING LN APT 104
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1273
Mailing Address - Country:US
Mailing Address - Phone:240-653-1333
Mailing Address - Fax:240-653-1333
Practice Address - Street 1:8828 HUNTING LN APT 104
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1273
Practice Address - Country:US
Practice Address - Phone:240-653-1333
Practice Address - Fax:240-653-1333
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD10275842579171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator