Provider Information for 1598491961
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TIEARRA CALDWELL
Sex: Female
NPI: 1598491961
Last Updated: 2022-07-28
Certification Date: 2022-07-28
Certification Date: 2022-07-28
Details
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NPI | 1598491961 | ||||||||
Enumeration Date | 2022-07-28 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 625 MONROE ST NE # C-284 WASHINGTON, DC 20017-1776 United States Phone: | Fax: | ||||||||
Primary Practice Address | 625 MONROE ST NE # C-284 WASHINGTON, DC 20017-1776 United States Phone: 980-303-0931 | Fax: | ||||||||
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