Individual
DEITHRA PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2327 14TH PL SE, WASHINGTON, DC 20020-4401
(202) 308-7036
Mailing address
2327 14TH PL SE, WASHINGTON, DC 20020-4401
(202) 308-7036
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070066632
—
DC
Enumeration date
12/01/2020
Last updated
12/01/2020
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