Individual
DEJANIQUE SHANICE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2338 PITTS PL SE APT 100, WASHINGTON, DC 20020-4986
(202) 704-2218
Mailing address
2337 PITTS PL SE APT 101, WASHINGTON, DC 20020-4969
(202) 704-2218
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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