Provider Demographics
NPI:1851737837
Name:TCHOUNGONG, ROLANDE STELLA
Entity Type:Individual
Prefix:
First Name:ROLANDE
Middle Name:STELLA
Last Name:TCHOUNGONG
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 1:10713 VENETIA MILL CIR APT 1B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1567
Mailing Address - Country:US
Mailing Address - Phone:571-494-9195
Mailing Address - Fax:
Practice Address - Street 1:10713 VENETIA MILL CIR APT 1B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1567
Practice Address - Country:US
Practice Address - Phone:571-494-9195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide