Provider Demographics
NPI:1194522474
Name:ACHA, THERESIA ATUH
Entity type:Individual
Prefix:
First Name:THERESIA
Middle Name:ATUH
Last Name:ACHA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 85TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4512
Mailing Address - Country:US
Mailing Address - Phone:240-413-5678
Mailing Address - Fax:
Practice Address - Street 1:5421 85TH AVE APT 1
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4512
Practice Address - Country:US
Practice Address - Phone:240-413-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200004427376K00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide