Provider Demographics
NPI:1952090177
Name:EPOSSI LOBE, CLARA LENYA
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:LENYA
Last Name:EPOSSI LOBE
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 1:13412 BLUEBEARD TER
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9459
Mailing Address - Country:US
Mailing Address - Phone:202-413-0272
Mailing Address - Fax:
Practice Address - Street 1:13412 BLUEBEARD TER
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-9459
Practice Address - Country:US
Practice Address - Phone:202-413-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200002553374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide