Individual
SHAMEKA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 13TH ST NW, WASHINGTON, DC 20009-5318
(202) 387-4434
Mailing address
2800 13TH ST NW, WASHINGTON, DC 20009-5318
(202) 387-4434
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029980900
—
DC
Enumeration date
06/25/2019
Last updated
06/25/2019
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