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Individual

TABITHA CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
32 BATES ST NW, WASHINGTON, DC 20001-1112
(202) 262-4412
Mailing address
5620 COLORADO AVE NW, WASHINGTON, DC 20011-7807
(202) 695-0709

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
70303228
DC
Enumeration date
04/18/2018
Last updated
04/18/2018
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