Provider Demographics
NPI:1861925547
Name:KAMFA, DELPHINE IJANG
Entity type:Individual
Prefix:
First Name:DELPHINE
Middle Name:IJANG
Last Name:KAMFA
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 1:9745 GOOD LUCK RD APT 9
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3322
Mailing Address - Country:US
Mailing Address - Phone:470-253-4035
Mailing Address - Fax:
Practice Address - Street 1:9745 GOOD LUCK RD APT 9
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3322
Practice Address - Country:US
Practice Address - Phone:470-263-4035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
WAHHA12727103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes374U00000XNursing Service Related ProvidersHome Health Aide