Individual
PETRA JUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2205 16TH ST SE, WASHINGTON, DC 20020-4333
(301) 370-8049
Mailing address
25 E WAYNE AVE # M706, SILVER SPRING, MD 20901-4264
(301) 370-8949
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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