Individual
MS. THEODORA REGINA PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW, LCSW-C
Contact information
Practice address
3035 ALABAMA AVE SE, WASHINGTON, DC 20020-3007
(202) 368-3542
Mailing address
3035 ALABAMA AVE SE, WASHINGTON, DC 20020-3007
(202) 368-3542
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
10678
MD
1041C0700X
Clinical Social Worker
Primary
LC302974
DC
Other
Enumeration date
08/20/2008
Last updated
06/12/2009
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