Provider Demographics
NPI:1255139390
Name:GOODING, SEQUINS CAMILLE
Entity type:Individual
Prefix:
First Name:SEQUINS
Middle Name:CAMILLE
Last Name:GOODING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 7TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2207
Mailing Address - Country:US
Mailing Address - Phone:973-392-8359
Mailing Address - Fax:
Practice Address - Street 1:4424 7TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2207
Practice Address - Country:US
Practice Address - Phone:973-392-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist