Individual
MISS MARY ALISE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 30TH ST SE, WASHINGTON, DC 20020-1674
(202) 241-2168
Mailing address
2396 ELVANS RD SE, WASHINGTON, DC 20020-3504
(202) 790-2335
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
DC
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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