Provider Demographics
NPI:1710795992
Name:BLESS, NKEGOAH TASONG
Entity type:Individual
Prefix:
First Name:NKEGOAH
Middle Name:TASONG
Last Name:BLESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13809 BRIARWOOD DR APT 1532
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1346
Mailing Address - Country:US
Mailing Address - Phone:443-584-5974
Mailing Address - Fax:
Practice Address - Street 1:13809 BRIARWOOD DR APT 1532
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1346
Practice Address - Country:US
Practice Address - Phone:540-609-4758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator