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Individual

KEMBA LEWIS SALUKVADZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1930 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7006
(202) 921-6628
Mailing address
6200 WESTCHESTER PARK DR, COLLEGE PARK, MD 20740-2853

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
02/08/2023
Last updated
02/08/2023
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