Individual
KEVIONNA HACKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4204 E CAPITOL ST NE APT 30, WASHINGTON, DC 20019-4469
(202) 492-0002
Mailing address
4204 E CAPITOL ST NE APT 30, WASHINGTON, DC 20019-4469
(202) 492-0002
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/06/2025
Last updated
06/18/2025
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