Healthcare Provider Details

I. General information

NPI: 1912843129
Provider Name (Legal Business Name): DAHMARI MOODY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 HALF ST SW
WASHINGTON DC
20024-3300
US

IV. Provider business mailing address

5236 MUDVILLE LN
WALDORF MD
20602-4220
US

V. Phone/Fax

Practice location:
  • Phone: 202-487-0957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: