Individual
TIARA CANDICE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
803 XENIA ST SE, WASHINGTON, DC 20032-3971
(202) 222-5017
Mailing address
1422 1ST ST SW APT 22, WASHINGTON, DC 20024-3508
(202) 222-5017
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
110023
DC
3747P1801X
Personal Care Attendant
—
DC
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
N/A
DC
05
—
90871020
—
DC
Enumeration date
03/03/2020
Last updated
03/03/2020
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