Provider Demographics
NPI:1487424586
Name:MBANGAH, TELMA NAAH
Entity type:Individual
Prefix:
First Name:TELMA
Middle Name:NAAH
Last Name:MBANGAH
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 1:14727 4TH ST UNIT 432
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3993
Mailing Address - Country:US
Mailing Address - Phone:214-622-0681
Mailing Address - Fax:
Practice Address - Street 1:14727 4TH ST UNIT 432
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3993
Practice Address - Country:US
Practice Address - Phone:214-622-0681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171M00000XOther Service ProvidersCase Manager/Care Coordinator