Healthcare Provider Details

I. General information

NPI: 1457457459
Provider Name (Legal Business Name): ALFIEE MATIESE BRELAND-NOBLE PH.D., MHSC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 WISCONSIN AVE NW STE 120 SUITE 120
WASHINGTON DC
20007-2265
US

IV. Provider business mailing address

2115 WISCONSIN AVE NW STE 120 SUITE 120
WASHINGTON DC
20007-2265
US

V. Phone/Fax

Practice location:
  • Phone: 202-687-2392
  • Fax:
Mailing address:
  • Phone: 202-687-2392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3250
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3250
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000818
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: