Individual
IDA LUCIA DIONE NA TATAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4645 NANNIE HELEN BURROUGHS AVE NE STE 103, WASHINGTON, DC 20019-3622
(202) 569-6272
Mailing address
4645 NANNIE HELEN BURROUGHS AVE NE STE 103, WASHINGTON, DC 20019-3622
(202) 569-6272
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/18/2023
Last updated
09/05/2023
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