Provider Demographics
NPI:1033669825
Name:ANCHI, TABITHA
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:ANCHI
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 1:2501 MARION BARRY AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3011
Mailing Address - Country:US
Mailing Address - Phone:202-866-7505
Mailing Address - Fax:202-866-7505
Practice Address - Street 1:2501 MARION BARRY AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3011
Practice Address - Country:US
Practice Address - Phone:202-723-3060
Practice Address - Fax:202-866-7505
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12384374U00000X
DC171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide