Provider Demographics
NPI:1952655292
Name:TCHAGNOU, JUVELINE
Entity Type:Individual
Prefix:
First Name:JUVELINE
Middle Name:
Last Name:TCHAGNOU
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 1:4 AUTUMN FLOWER LN
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2600
Mailing Address - Country:US
Mailing Address - Phone:240-388-7552
Mailing Address - Fax:
Practice Address - Street 1:4 AUTUMN FLOWER LN
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2600
Practice Address - Country:US
Practice Address - Phone:240-388-7552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide