Individual
CHANDRA HARRIS WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2712 GAILLARDIA RD, JACKSONVILLE, FL 32211
(904) 486-0412
Mailing address
2712 GAILLARDIA RD, JACKSONVILLE, FL 32211-4029
(904) 486-0412
(904) 486-0412
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023370200
—
FL
Enumeration date
05/22/2018
Last updated
05/22/2018
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