Provider Demographics
NPI:1790310639
Name:TEMELSO, ABREHET
Entity Type:Individual
Prefix:
First Name:ABREHET
Middle Name:
Last Name:TEMELSO
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 1:4522 31ST ST S APT 203
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2131
Mailing Address - Country:US
Mailing Address - Phone:703-624-2509
Mailing Address - Fax:
Practice Address - Street 1:2001 15TH ST NW APT 1003
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-5830
Practice Address - Country:US
Practice Address - Phone:202-855-1369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant