Organization
THE MECCA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEISHA L MACK PHD (LICENSED CLINICAL PSYHOLOGIST)
(202) 529-3117
Entity
Organization
Contact information
Practice address
1050 17TH ST NW, SUITE 800, WASHINGTON, DC 20036-5503
(202) 529-3117
(202) 529-3117
Mailing address
1050 17TH ST NW, SUITE 800, WASHINGTON, DC 20036-5503
(202) 529-3117
(202) 529-3117
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/26/2007
Last updated
02/24/2014
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