Provider Demographics
NPI:1386995306
Name:FOWORA, DOROTHEA
Entity type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:
Last Name:FOWORA
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 1:1912 ROSEMARY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2447
Mailing Address - Country:US
Mailing Address - Phone:240-472-2711
Mailing Address - Fax:
Practice Address - Street 1:2000 TOWER OAKS BLVD STE 500
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4377
Practice Address - Country:US
Practice Address - Phone:301-444-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No374U00000XNursing Service Related ProvidersHome Health Aide