Individual
CHANCELINE Y LATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 12TH ST SE STE G35, WASHINGTON, DC 20003-3738
(202) 544-8090
(202) 544-8091
Mailing address
4516 FORT TOTTEN DR NE # 17, WASHINGTON, DC 20011-7523
(202) 550-8322
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13798
DC
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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