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General NPI Number Information
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NPI Number | 1235824988
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Entity Type | Individual
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Provider Name | SHONTA CONYER
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Gender | Female
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 852 BARNABY ST SE APT 201
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City | WASHINGTON
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State | DC
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Zip | 20032-3907
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Country | US
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Telephone | 202-450-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 CEDAR ST SE APT 101
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City | WASHINGTON
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State | DC
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Zip | 20020-5002
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Country | US
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Telephone | 202-684-1391
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | DC
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