Healthcare Provider Details

I. General information

NPI: 1336027382
Provider Name (Legal Business Name): ROSEMARIE NICOME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 BARNEY STREET SE APT113
WASHINGTON DC DC
20032
US

IV. Provider business mailing address

1512 ROUNDHILL RD
BALTIMORE MD
21218-2211
US

V. Phone/Fax

Practice location:
  • Phone: 202-340-9552
  • Fax:
Mailing address:
  • Phone: 240-480-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: