Provider Demographics
NPI:1104627629
Name:TOWA, LEOPOLDINE TCHANA
Entity type:Individual
Prefix:
First Name:LEOPOLDINE
Middle Name:TCHANA
Last Name:TOWA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13908 BRIARWOOD DR APT 2124
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1336
Mailing Address - Country:US
Mailing Address - Phone:240-701-3055
Mailing Address - Fax:
Practice Address - Street 1:13908 BRIARWOOD DR APT 2124
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1336
Practice Address - Country:US
Practice Address - Phone:240-701-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200004339374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide