Barbara Ambomu

Individual provider Active NPI Case Manager/Care Coordinator · Clinton, MD

NPI 1407535396 · NPPES record last updated Jan 23, 2025

Key facts

NPI
1407535396
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
11405 Hershey Red PL
Clinton, MD 20735-2622
Phone
(202) 823-8881
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1407535396DCMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193200000X MULTI-SPECIALTY GROUP
106S00000X 1407535396 DC
Community Health Worker
Group: 193200000X MULTI-SPECIALTY GROUP
172V00000X
Case Manager/Care Coordinator
Group: 193200000X MULTI-SPECIALTY GROUP
171M00000X Yes

Addresses

Primary practice location

11405 Hershey Red PL
Clinton, MD 20735-2622

Mailing address

9517 Muirkirk Rd Apt 101
Laurel, MD 20708-2767

Other providers in Clinton, MD

All providers in Clinton, MD · Case Manager/Care Coordinator in Maryland

Sources for this page

Verify at the official NPI Registry.