Individual
CHARLETTE SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 BRYANT ST NE, WASHINGTON, DC 20002-1119
(202) 971-5364
Mailing address
1511 DECEMBER DR APT 404, SILVER SPRING, MD 20904-3619
(240) 705-0357
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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