Provider Demographics
NPI:1801372164
Name:SANJO EPSE WANDJI, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:SANJO EPSE WANDJI
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 1:11712 HEARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1575
Mailing Address - Country:US
Mailing Address - Phone:301-836-8370
Mailing Address - Fax:
Practice Address - Street 1:11712 HEARTWOOD DR
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1575
Practice Address - Country:US
Practice Address - Phone:301-836-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant