Individual
TABE NKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
502 KENNEDY ST NW, WASHINGTON, DC 20011-3136
(202) 313-7283
Mailing address
931 CASLON WAY APT 104, HYATTSVILLE, MD 20785-6005
(240) 510-8595
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CACII200001243
DC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CACII200001243
DC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/14/2021
Last updated
07/11/2024
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