Provider Demographics
NPI:1053961961
Name:CLAGGETT, LAVENE ELIZABETH
Entity type:Individual
Prefix:
First Name:LAVENE
Middle Name:ELIZABETH
Last Name:CLAGGETT
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 1:2513 GAITHER ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-3029
Mailing Address - Country:US
Mailing Address - Phone:202-367-4417
Mailing Address - Fax:
Practice Address - Street 1:1220 44TH PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5709
Practice Address - Country:US
Practice Address - Phone:202-367-4417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant