Provider Demographics
NPI:1821594417
Name:MANYOH, CLARA NSOH
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:NSOH
Last Name:MANYOH
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 1:10001 GREENBELT RD APT 101
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2227
Mailing Address - Country:US
Mailing Address - Phone:301-683-4217
Mailing Address - Fax:
Practice Address - Street 1:10001 GREENBELT RD APT 101
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2227
Practice Address - Country:US
Practice Address - Phone:301-683-4217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13564374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide