Individual
THAISSA ELIZABETH SHIVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 547-8540
(202) 610-7147
Mailing address
7062 DUCKETTS LN APT 301, ELKRIDGE, MD 21075-6990
(301) 266-6012
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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