Provider Demographics
NPI:1336491117
Name:TIMOH, SUSANA NGAMTII (HHA)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:NGAMTII
Last Name:TIMOH
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 1:9738 COUNTRY MEADOWS LN APT 3D
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-6308
Mailing Address - Country:US
Mailing Address - Phone:301-497-6111
Mailing Address - Fax:
Practice Address - Street 1:9738 COUNTRY MEADOWS LN APT 3D
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-6308
Practice Address - Country:US
Practice Address - Phone:301-497-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC20667171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor