Provider Demographics
NPI:1467009597
Name:MINOR, ALICIA A
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:A
Last Name:MINOR
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 1:1926 SAVANNAH ST SE APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7534
Mailing Address - Country:US
Mailing Address - Phone:202-845-2613
Mailing Address - Fax:
Practice Address - Street 1:1926 SAVANNAH ST SE APT 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7534
Practice Address - Country:US
Practice Address - Phone:202-845-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant