Individual
MICHELE MBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5101 WISCONSIN AVE NW, WASHINGTON, DC 20016-4120
(202) 618-9125
Mailing address
761 UPSAL ST SE, WASHINGTON, DC 20032-4123
(202) 945-7067
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
RN1013158
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN1013158
DC
Other
Enumeration date
11/15/2013
Last updated
07/01/2021
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