Individual
SHAUNTISE EBONY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3908 8TH ST SE, WASHINGTON, DC 20032-3733
(202) 808-9657
Mailing address
705 YUMA ST SE, WASHINGTON, DC 20032-3756
(202) 427-7902
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/11/2021
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