Provider Demographics
NPI:1063253698
Name:AGULABA AMBI, HELMINE EGOKOM
Entity type:Individual
Prefix:
First Name:HELMINE EGOKOM
Middle Name:
Last Name:AGULABA AMBI
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 1:2012 SAINT JOSEPHS DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1889
Mailing Address - Country:US
Mailing Address - Phone:240-909-0250
Mailing Address - Fax:
Practice Address - Street 1:2012 SAINT JOSEPHS DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1889
Practice Address - Country:US
Practice Address - Phone:240-909-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator