Individual
TYQUAN FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3913 SOUTHERN AVE, SUITLAND, MD 20746-1950
(202) 341-2590
Mailing address
3913 SOUTHERN AVE, SUITLAND, MD 20746
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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