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General NPI Number Information
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NPI Number | 1033784723
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Entity Type | Individual
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Provider Name | PROF. SHANTAE ONEAL
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 36 T ST NE # E201
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City | WASHINGTON
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State | DC
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Zip | 20002-1536
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Country | US
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Telephone | 202-489-3820
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Fax |
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Provider Business Mailing Address
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Address Line | 36 T ST. N.E. 201
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City | WASHINGTON
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State | DC
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Zip | 20002
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Country | US
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Telephone | 202-489-3820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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