Individual
IVORY LAKEIA DANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2908 16TH ST NE, WASHINGTON, DC 20018-1822
(202) 269-0375
Mailing address
9722 MEMPHIS PL, WALDORF, MD 20603-3865
(240) 230-2129
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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