Provider Demographics
NPI:1851975239
Name:WYLIE, ATTICA CONSUELLA
Entity Type:Individual
Prefix:
First Name:ATTICA
Middle Name:CONSUELLA
Last Name:WYLIE
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 1:2301 CHAMPLAIN ST NW APT T07
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-8706
Mailing Address - Country:US
Mailing Address - Phone:202-243-9598
Mailing Address - Fax:
Practice Address - Street 1:2301 CHAMPLAIN ST NW APT T07
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-8706
Practice Address - Country:US
Practice Address - Phone:202-243-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty