Individual
LAVONCYE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 GOOD HOPE RD SE, WASHINGTON, DC 20020-6912
(202) 610-1886
(202) 610-1887
Mailing address
1596 ADDISON RD S, DISTRICT HEIGHTS, MD 20747-1565
(240) 766-9183
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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