Individual
BENNAVIA WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
302 54TH ST NE, APT. 21, WASHINGTON, DC 20019-6630
(202) 817-5503
Mailing address
302 54TH ST NE, APT. 21, WASHINGTON, DC 20019-6630
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA8961
DC
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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