Healthcare Provider Details

I. General information

NPI: 1609345933
Provider Name (Legal Business Name): EMILIE BERNALIE JOSEPH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 CONNECTICUT AVE NW STE 800
WASHINGTON DC
20036-1733
US

IV. Provider business mailing address

1350 CONNECTICUT AVE NW STE 800
WASHINGTON DC
20036-1733
US

V. Phone/Fax

Practice location:
  • Phone: 202-986-5941
  • Fax:
Mailing address:
  • Phone: 202-986-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1001385
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: