Individual
KIDIST DEGAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7513 MAPLE AVE, TAKOMA PARK, MD 20912-4903
(404) 291-3562
Mailing address
7513 MAPLE AVE, TAKOMA PARK, MD 20912-4903
(404) 291-3562
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA200003854
DC
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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