Provider Demographics
NPI:1629832084
Name:HYMES-GOODALL, DIONNE CONSTANCE
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:CONSTANCE
Last Name:HYMES-GOODALL
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 1:3403 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-2841
Mailing Address - Country:US
Mailing Address - Phone:202-746-7111
Mailing Address - Fax:
Practice Address - Street 1:3750 JAMISON ST NE APT 349
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-4466
Practice Address - Country:US
Practice Address - Phone:202-701-0716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant