Individual
KIM MONIQUE BODDIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-3865
(202) 894-8411
(202) 897-1198
Mailing address
10467 CAMPUS WAY S, UPPER MARLBORO, MD 20774-1330
(301) 350-9853
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
05/21/2024
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