Healthcare Provider Details

I. General information

NPI: 1689286411
Provider Name (Legal Business Name): TIERRA D HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2020
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 BLADENSBURG RD NE
WASHINGTON DC
20018-1440
US

IV. Provider business mailing address

2408 BRIGHTSEAT RD APT 2
HYATTSVILLE MD
20785-3544
US

V. Phone/Fax

Practice location:
  • Phone: 202-407-7747
  • Fax:
Mailing address:
  • Phone: 301-661-2820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200001594
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP10693
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: