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NPI Code Detail

MEDICARE: DORTHEA ALEASE HARRIS

MEDICARE: DORTHEA ALEASE HARRIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1154883254
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORTHEA ALEASE HARRIS
Provider Business Mailing Address
First Line : 558 MALCOLM X AVE SE APT 2
Second Line :
City : WASHINGTON
State : DC
Zip : 20032-2591
Country : US
Telephone Number : 202-423-4861
Fax Number :
Provider Business Practice Location Address
First Line : 3298 FORT LINCOLN DR NE APT 1010
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-4342
Country : US
Telephone Number : 202-709-2607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2019
Last Update Date : 04/05/2019

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Directions to “ DORTHEA ALEASE HARRIS ” Practice Location

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