Individual
CLINTON CHICK NDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3254 GOSSETT CT, WALDORF, MD 20603-3784
(202) 300-6822
Mailing address
3254 GOSSETT CT, WALDORF, MD 20603-3784
(202) 300-6822
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
DC
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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