Healthcare Provider Details

I. General information

NPI: 1497202634
Provider Name (Legal Business Name): LINDSEY DENISE VANCE L.P.C., ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE SUITE 234
WASHINGTON DC
20020-7024
US

IV. Provider business mailing address

2041 MARTIN LUTHER KING JR AVE SE SUITE 234
WASHINGTON DC
20020-7024
US

V. Phone/Fax

Practice location:
  • Phone: 202-610-0066
  • Fax:
Mailing address:
  • Phone: 202-610-0066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPRC14442
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberATCB 13-253
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: