Individual
AUGUSTINE AJALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3348 BLAINE ST NE, WASHINGTON, DC 20019-1327
(202) 399-2966
Mailing address
13408 COLDWATER DR, FORT WASHINGTON, MD 20744-5428
(443) 204-4065
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/27/2019
Last updated
07/26/2023
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