Individual
DEANETTA DENISE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 SARATOGA AVE NE, WASHINGTON, DC 20018-1923
(202) 440-7204
Mailing address
2721 LANGSTON PL SE, WASHINGTON, DC 20020-3238
(202) 718-4704
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
1963374
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90867031
—
DC
Enumeration date
05/28/2021
Last updated
05/28/2021
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