Provider Demographics
NPI:1093590333
Name:BOH, CHRISTA MARIA AKFUA
Entity type:Individual
Prefix:
First Name:CHRISTA MARIA
Middle Name:AKFUA
Last Name:BOH
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 1:6904 ANDERSONS WAY APT 104
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6964
Mailing Address - Country:US
Mailing Address - Phone:701-215-2683
Mailing Address - Fax:
Practice Address - Street 1:9783 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3340
Practice Address - Country:US
Practice Address - Phone:170-121-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X, 172V00000X
DCHHA200002936374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide