Individual
ERICA BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4638 H ST SE, WASHINGTON, DC 20019-4981
(202) 243-0693
Mailing address
770 ATLANTIC ST SE, WASHINGTON, DC 20032-3739
(202) 638-9864
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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