JACKSON NJI FONLON TANIFORM NGWA

CAPITOL HEIGHTS, MD
NPI1467264515
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2025-01-24
Last Update Date2025-01-27
Business Address
JACKSON NJI FONLON TANIFORM NGWA
5221 CAPITOL HEIGHTS
CAPITOL HEIGHTS, MD 20743
Phone number: 913-494-2143
Mailing Address
JACKSON NJI FONLON TANIFORM NGWA
5221 CAPITOL HEIGHTS
CAPITOL HEIGHTS, MD 20743
Phone number: 913-494-2143
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