Provider Demographics
NPI:1508663535
Name:NGO YAMB, MARIE DESIRE LAFORTUNE
Entity type:Individual
Prefix:
First Name:MARIE DESIRE
Middle Name:LAFORTUNE
Last Name:NGO YAMB
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 1:5407 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3439
Mailing Address - Country:US
Mailing Address - Phone:240-886-5439
Mailing Address - Fax:
Practice Address - Street 1:5407 15TH AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3439
Practice Address - Country:US
Practice Address - Phone:240-886-5439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator