Individual
DERRICK LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 R ST SE APT 206, WASHINGTON, DC 20020-3952
(202) 584-4060
Mailing address
2650 Q ST SE APT 303, WASHINGTON, DC 20020-3938
(202) 725-1376
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
DC
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90894272
—
DC
Enumeration date
06/12/2020
Last updated
06/12/2020
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