Gideon Fonkwen
Case Manager/Care Coordinator in Rockville, MD. Individual provider (NPI-1).
NPI number1063195170
StatusActive
Last updated in NPPESJul 3, 2024
Details
- NPI
- 1063195170
- Entity type
- Individual (NPI-1)
- Name
- Gideon Fonkwen
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 8, 2023
- Certification date
- Jul 3, 2024
- Last updated
- Jul 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 106S00000X | Behavior Technician | – | – |
Practice location
2000 Tower Oaks BlvdRockville, MD 20852-4282
Phone 301-444-5001
Mailing address
2000 Tower Oaks BlvdRockville, MD 20852-4282
Phone 301-444-5001
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