Healthcare Provider Details

I. General information

NPI: 1982960290
Provider Name (Legal Business Name): D GAMBLES & ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PENNSYLVANIA AVE NW 4TH FLOOR, EAST TOWER
WASHINGTON DC
20037-1701
US

IV. Provider business mailing address

2200 PENNSYLVANIA AVE NW 4TH FLOOR, EAST TOWER
WASHINGTON DC
20037-1701
US

V. Phone/Fax

Practice location:
  • Phone: 202-507-5725
  • Fax: 202-507-5726
Mailing address:
  • Phone: 202-507-5725
  • Fax: 202-507-5726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000622
License Number StateDE

VIII. Authorized Official

Name: DR. DEBORAH GAMBLES
Title or Position: OWNER
Credential: PSYD
Phone: 202-507-5727