Provider Demographics
NPI:1447059704
Name:MOFOR, PRISCILIA ZELEFAC
Entity type:Individual
Prefix:
First Name:PRISCILIA
Middle Name:ZELEFAC
Last Name:MOFOR
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 1:813 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3940
Mailing Address - Country:US
Mailing Address - Phone:240-708-0615
Mailing Address - Fax:
Practice Address - Street 1:813 8TH ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3940
Practice Address - Country:US
Practice Address - Phone:240-708-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator