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Individual

KIDIST AMARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5021 SEMINARY RD APT 603, ALEXANDRIA, VA 22311-1930
(571) 244-7014
Mailing address
5021 SEMINARY RD APT 603, ALEXANDRIA, VA 22311-1930

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
VA
3747P1801X
Personal Care Attendant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3747P1801X
VA
Enumeration date
04/19/2019
Last updated
04/19/2019
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