Individual
DELORIS BLAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 ELMIRA ST SW, WASHINGTON, DC 20032-2266
(202) 817-4742
Mailing address
113 ELMIRA ST SW, WASHINGTON, DC 20032-2266
(202) 817-4742
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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