Provider Demographics
NPI:1902167612
Name:TUMENTA, COLETTE
Entity Type:Individual
Prefix:MRS
First Name:COLETTE
Middle Name:
Last Name:TUMENTA
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 1:1209 RYON WAY
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1777
Mailing Address - Country:US
Mailing Address - Phone:240-302-0975
Mailing Address - Fax:
Practice Address - Street 1:1209 RYON WAY
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1777
Practice Address - Country:US
Practice Address - Phone:240-302-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide