Provider Demographics
NPI:1194446518
Name:ALSBROOKS, SHANNON LATOSSHA
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LATOSSHA
Last Name:ALSBROOKS
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 1:762 GRESHAM PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3824
Mailing Address - Country:US
Mailing Address - Phone:202-644-1304
Mailing Address - Fax:
Practice Address - Street 1:2520 10TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1740
Practice Address - Country:US
Practice Address - Phone:202-644-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant