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Individual

KAYLIA DINECE BULTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1617 MONTANA AVE NE, WASHINGTON, DC 20018-1203
(202) 946-0059
Mailing address
1617 MONTANA AVE NE, WASHINGTON, DC 20018-1203
(202) 946-0059

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12345
DC
Enumeration date
10/08/2020
Last updated
10/08/2020
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