Provider Demographics
NPI:1548964364
Name:MBELLE OHANDJA, JEANNE CARINE
Entity type:Individual
Prefix:MRS
First Name:JEANNE CARINE
Middle Name:
Last Name:MBELLE OHANDJA
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 1:1190 W NORTHERN PKWY APT 309
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1452
Mailing Address - Country:US
Mailing Address - Phone:240-381-2672
Mailing Address - Fax:
Practice Address - Street 1:1190 W NORTHERN PKWY APT 309
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1452
Practice Address - Country:US
Practice Address - Phone:240-381-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health