Individual
PHINA WACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 547-8450
Mailing address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 547-8450
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
01/03/2012
Last updated
04/12/2023
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