Healthcare Provider Details

I. General information

NPI: 1528717279
Provider Name (Legal Business Name): ALEESHA OBRIEN M. E.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 K ST NW STE 400
WASHINGTON DC
20006-1711
US

IV. Provider business mailing address

25722 VALLEY PARK TER
DAMASCUS MD
20872-2386
US

V. Phone/Fax

Practice location:
  • Phone: 202-517-5112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC00846
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: