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Individual

HEATHER LYNN DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW-C, RN

Contact information

Practice address
1418 MARION BARRY AVE SE, WASHINGTON, DC 20020-5615
(202) 796-5000
Mailing address
PO BOX 102904, PASADENA, CA 91189-0140
(810) 643-1418

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
21007
MD
1041C0700X
Clinical Social Worker
LC200002117
DC
1041C0700X
Clinical Social Worker
163W00000X
Registered Nurse
Primary
RN500004103
DC

Other

Enumeration date
06/27/2023
Last updated
06/25/2024
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