Ghislaine Kenmegne Datouo Mogo
Nurse Practitioner, Psych/Mental Health in Washington, DC. Individual provider (NPI-1).
NPI number1164064705
StatusActive
Last updated in NPPESOct 15, 2019
Details
- NPI
- 1164064705
- Entity type
- Individual (NPI-1)
- Name
- Ghislaine Kenmegne Datouo Mogo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 15, 2019
- Last updated
- Oct 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | RN1028252 | DC | Yes |
Practice location
4130 Hunt Pl NeWashington, DC 20019-3565
Phone 202-679-0620
Mailing address
9580 Muirkirk Rd Apt 101Laurel, MD 20708-2717
Phone 240-705-1096
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