Individual
MYLACHI MIKYA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
339 RIDGE RD SE, WASHINGTON, DC 20019-3266
(240) 429-2880
Mailing address
339 RIDGE RD SE, WASHINGTON, DC 20019-3266
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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