Healthcare Provider Details

I. General information

NPI: 1326827858
Provider Name (Legal Business Name): BRIEANNA JASMINE MOYD M. ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 MASSACHUSETTS AVE SE
WASHINGTON DC
20019-5620
US

IV. Provider business mailing address

806 CHANNING PL NE APT 412B
WASHINGTON DC
20018-1770
US

V. Phone/Fax

Practice location:
  • Phone: 202-803-7004
  • Fax:
Mailing address:
  • Phone: 410-812-5434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: