Provider Demographics
NPI:1114685559
Name:MASON, TERKIRIA ANGELISE (HHA)
Entity Type:Individual
Prefix:
First Name:TERKIRIA
Middle Name:ANGELISE
Last Name:MASON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 ROBINSON PL SE APT 204
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-8017
Mailing Address - Country:US
Mailing Address - Phone:202-981-1262
Mailing Address - Fax:
Practice Address - Street 1:3016 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2524
Practice Address - Country:US
Practice Address - Phone:202-561-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200001526374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide