Boys Town Washington Dc, INC.
Psychologist in Silver Spring, MD. Organization (NPI-2).
NPI number1134828130
StatusActive
Last updated in NPPESMar 14, 2023
Details
- NPI
- 1134828130
- Entity type
- Organization (NPI-2)
- Legal business name
- Boys Town Washington Dc, INC.
- Organization subpart
- No
- Enumeration date
- Feb 28, 2023
- Certification date
- Mar 14, 2023
- Last updated
- Mar 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | – | – | Yes |
Practice location
10750 Columbia Pike Ste 502Silver Spring, MD 20901-4460
Phone 202-650-6361 · Fax 202-250-6362
Mailing address
4801 Sargent Rd NeWashington, DC 20017-2841
Phone 202-650-6361 · Fax 202-250-6362
Authorized official
Stacia Jean Shearman
Credentialing Specialist
5313558104
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