Organization
ABOUT A HEALTHY BRAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA APRIL LATOAK LEE PMHNP B.C. (NURSE PRACTITIONER)
(240) 756-1682
Entity
Organization
Contact information
Practice address
19403 BUCKINGHAM WAY, GERMANTOWN, MD 20874-4665
(240) 756-1682
Mailing address
12774 WISTERIA DR, 2724, GERMANTOWN, MD 20875
(240) 756-1682
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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