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General NPI Number Information
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NPI Number | 1801553896
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Entity Type | Individual
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Provider Name | CHYRA CHURCH
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Gender | Female
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Dates
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Enumeration Date | 11/24/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 650 I ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-4350
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Country | US
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Telephone | 240-324-6524
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Fax |
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Provider Business Mailing Address
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Address Line | 7307 FOXBRANCH CT
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City | CLINTON
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State | MD
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Zip | 20735-3073
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Country | US
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Telephone | 301-928-9170
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LG50083336
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License Number State | DC
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