Individual
CHARNELL KAMISHA GOODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5930 SOUTHERN AVE SE, WASHINGTON, DC 20019-6553
(202) 790-0111
Mailing address
5930 SOUTHERN AVE SE, WASHINGTON, DC 20019-6553
(202) 790-0111
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70422087
—
DC
Enumeration date
12/17/2019
Last updated
12/17/2019
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