Individual
ITA MBU UH FRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 18TH ST NE, WASHINGTON, DC 20018-2738
(202) 529-6510
(202) 529-6570
Mailing address
13916 CASTLE BLVD APT T2, SILVER SPRING, MD 20904-4952
(202) 386-0561
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA14509
DC
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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