Individual
JIRE DADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9314 CHERRY HILL RD APT 915, COLLEGE PARK, MD 20740-1253
(240) 708-1817
Mailing address
9314 CHERRY HILL RD APT 915, COLLEGE PARK, MD 20740-1253
(240) 708-1817
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12779
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3942439
DRIVER LICENSE
DC
Enumeration date
06/07/2017
Last updated
07/21/2022
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