Provider Demographics
NPI:1659192433
Name:WASHINGTON, ALICIA MEL
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MEL
Last Name:WASHINGTON
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:PO BOX 2700
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-2700
Mailing Address - Country:US
Mailing Address - Phone:706-251-6944
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2700
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30914-2700
Practice Address - Country:US
Practice Address - Phone:706-251-6944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health