Individual
FONTAVIA TAMMY GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 IRVINGTON ST SW APT 102, WASHINGTON, DC 20032-1057
(202) 717-4504
Mailing address
104 IRVINGTON ST SW APT 102, WASHINGTON, DC 20032-1057
(202) 717-4504
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70356705
—
DC
Enumeration date
11/23/2018
Last updated
11/23/2018
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