Mirabel Tenjolt Mukum

Name

Mirabel Tenjolt Mukum

Year of birth

1981

Source

USA - Health and Human Services List of Excluded Individuals and Entities

Aliases

Mirabel Tenjolt Mukum

Privacy Request

Additional Information

General: EMPLOYEE - PRIVATE S

Specialty: PERSONAL CARE PROVID

Medical license number: 1700152055

Address: 9003 BRIGHTLEA COURT

City: LANHAM

State: MD

Zip code: 20706

Exclusion type: Conviction of program-related crimes. Minimum Period: 5 years (Social Security Act: 1128(a)(1), 42 USC §: 1320a-7(a)(1))

Exclusion date: 2015-06-18


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