Individual
MS. DAVINA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6401 GOLDEN TRIANGLE DR STE 115, GREENBELT, MD 20770-3261
(202) 549-8890
Mailing address
6401 GOLDEN TRIANGLE DR STE 115, GREENBELT, MD 20770-3261
(202) 549-8890
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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