Provider Demographics
NPI:1225390099
Name:TAZOH, NDELEPI SOLANGE
Entity type:Individual
Prefix:
First Name:NDELEPI
Middle Name:SOLANGE
Last Name:TAZOH
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 1:9741 GOOD LUCK RD APT 12
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3320
Mailing Address - Country:US
Mailing Address - Phone:202-642-8972
Mailing Address - Fax:
Practice Address - Street 1:2811 PENSYLVANNIA AVE SE LL
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020
Practice Address - Country:US
Practice Address - Phone:202-894-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171M00000X
251S00000X, 3747P1801X
DC171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant