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Individual

ANTIONETTE COUSAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
107 58TH ST SE, WASHINGTON, DC 20019-6546
(267) 970-1069
Mailing address
107 58TH ST SE, WASHINGTON, DC 20019-6546
(267) 970-1069

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
09/27/2023
Last updated
09/27/2023
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