Individual
MISS KIDIST NIGUSSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 CHARLES ST, FALLS CHURCH, VA 22041-1902
(862) 438-4402
Mailing address
5055 SEMINARY RD APT 1640, ALEXANDRIA, VA 22311-2025
(862) 438-4402
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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