Tyisha Jamilla Smallwood
Case Manager/Care Coordinator in Washington, DC. Individual provider (NPI-1).
NPI number1619706447
StatusActive
Last updated in NPPESJul 30, 2024
Details
- NPI
- 1619706447
- Entity type
- Individual (NPI-1)
- Name
- Tyisha Jamilla Smallwood
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 30, 2024
- Certification date
- Jul 30, 2024
- Last updated
- Jul 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
2041 Martin Luther King Jr Ave SeWashington, DC 20020-7024
Phone 202-547-8540 · Fax 202-610-7147
Mailing address
2534 14th St Ne Apt 1Washington, DC 20018-1927
Phone 202-793-9265
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