Provider Demographics
NPI:1336710359
Name:COLLINGTON, LATRICE
Entity type:Individual
Prefix:
First Name:LATRICE
Middle Name:
Last Name:COLLINGTON
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 1:16330 BADEN WESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-8475
Mailing Address - Country:US
Mailing Address - Phone:202-270-0958
Mailing Address - Fax:
Practice Address - Street 1:2 M ST NE APT 718
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3989
Practice Address - Country:US
Practice Address - Phone:240-606-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant