Individual
LYDIA TITY JANNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14090 BIG CREST LN APT 207, WOODBRIDGE, VA 22191-5531
(157) 477-8097
Mailing address
4 FLEWELLEN DR, STAFFORD, VA 22554-7829
(571) 477-8097
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
1401161534
VA
171M00000X
Case Manager/Care Coordinator
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
VA
Other
Enumeration date
11/13/2023
Last updated
03/31/2025
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