Provider Demographics
NPI:1134936909
Name:YOMI EPSE ZOUTOUOP, HENRIETTE
Entity type:Individual
Prefix:
First Name:HENRIETTE
Middle Name:
Last Name:YOMI EPSE ZOUTOUOP
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 1:11378 CHERRY HILL RD UNIT 304
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3771
Mailing Address - Country:US
Mailing Address - Phone:240-642-8206
Mailing Address - Fax:
Practice Address - Street 1:11378 CHERRY HILL RD UNIT 304
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3771
Practice Address - Country:US
Practice Address - Phone:240-642-8206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide