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Individual

SHAHIDAH SHABAZZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5011 9TH ST NW, WASHINGTON, DC 20011-3915
(202) 253-2047
Mailing address
1010 VERMONT AVE NW STE 1003, WASHINGTON, DC 20005-4927
(844) 381-4432

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05
DC
Enumeration date
02/12/2019
Last updated
02/12/2019
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