Individual provider · Type 1 NPI
Ida Mabelle Konchou, HHA
Psychiatric/Mental Health Nurse Practitioner · Takoma Park, MD
NPI number
1134482078
Active
Practice location
6731 New Hampshire Ave Apt 409
Takoma Park, MD 20912-2801
Fax (202) 545-0934
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R207705 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1134482078
Ida Mabelle Konchou, HHA's National Provider Identifier is 1134482078, issued on Jun 15, 2012. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Takoma Park, MD. The record was last updated on Mar 20, 2020.