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Individual

TABE OBI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 547-8450
Mailing address
7826 EASTERN AVE NW, LL16, WASHINGTON, DC 20012-1324
(202) 723-1100

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
374U00000X
Home Health Aide

Other

Enumeration date
01/22/2015
Last updated
03/22/2023
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