Individual
MIRACLE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 CONGRESS PL SE APT 204, WASHINGTON, DC 20020-2952
(771) 201-4642
Mailing address
1400 CONGRESS PL SE APT 204, WASHINGTON, DC 20020-2952
(771) 201-4642
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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