Provider Demographics
NPI:1851770374
Name:YOVO, CELIA ALICIA AKOSSIWA ESSI
Entity Type:Individual
Prefix:
First Name:CELIA ALICIA
Middle Name:AKOSSIWA ESSI
Last Name:YOVO
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 1:4821 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-5731
Mailing Address - Country:US
Mailing Address - Phone:443-722-1156
Mailing Address - Fax:
Practice Address - Street 1:4821 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-5731
Practice Address - Country:US
Practice Address - Phone:443-722-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4275314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility