Provider Demographics
NPI:1780308619
Name:JENIFER, NATOSHA (HL)
Entity type:Individual
Prefix:MS
First Name:NATOSHA
Middle Name:
Last Name:JENIFER
Suffix:
Gender:F
Credentials:HL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 TARPON CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4783
Mailing Address - Country:US
Mailing Address - Phone:202-262-7186
Mailing Address - Fax:
Practice Address - Street 1:1418 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5615
Practice Address - Country:US
Practice Address - Phone:202-796-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator