Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MT007839 | GA |
NPI | 1184177362 |
---|---|
Provider Name | Akiscia Washington |
First Address | Atlanta, GA 30363-1073 |
Second Address | Atlanta, GA 30363-1073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2016 |
Last Update Date | 25/07/2016 |