| NPI | 1861036196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQLYN DAWN JOHNSON Owner 202-495-1581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2021-06-09 |