Individual
MISPA AMBEI ACHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 BRYAN PL SE, WASHINGTON, DC 20020-4417
(202) 894-6811
Mailing address
5644 WHITFIELD CHAPEL RD APT 301, LANHAM, MD 20706-2560
(301) 728-8790
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/20/2023
Last updated
07/23/2023
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