Provider Demographics
NPI:1205228269
Name:TABRON, CHONTIE LETRISHA
Entity Type:Individual
Prefix:
First Name:CHONTIE
Middle Name:LETRISHA
Last Name:TABRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6031 KANSAS AVE NW UNIT 201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1566
Mailing Address - Country:US
Mailing Address - Phone:202-545-5040
Mailing Address - Fax:202-545-5043
Practice Address - Street 1:6031 KANSAS AVE NW UNIT 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1566
Practice Address - Country:US
Practice Address - Phone:202-545-5040
Practice Address - Fax:202-545-5043
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA9476251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health