Provider Demographics
NPI:1255775136
Name:ADADEVOH, LILY ADJOKO (HHA)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:ADJOKO
Last Name:ADADEVOH
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21798-8842
Mailing Address - Country:US
Mailing Address - Phone:240-464-3934
Mailing Address - Fax:
Practice Address - Street 1:612 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSBORO
Practice Address - State:MD
Practice Address - Zip Code:21798-8842
Practice Address - Country:US
Practice Address - Phone:240-464-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health