Individual
KENNISHA AVONTIA MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2656 BOWEN RD SE APT 202, WASHINGTON, DC 20020-6612
(202) 718-6501
Mailing address
3201 WEEPING WILLOW CT APT 24, SILVER SPRING, MD 20906-2569
(240) 455-8054
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
MD
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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