Healthcare Provider Details

I. General information

NPI: 1619195609
Provider Name (Legal Business Name): KRISTIN ALYCE DAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 VERMONT AVE NW
WASHINGTON DC
20420-0001
US

IV. Provider business mailing address

7506 LAMOYNE CT
ALEXANDRIA VA
22315-5914
US

V. Phone/Fax

Practice location:
  • Phone: 202-273-8549
  • Fax:
Mailing address:
  • Phone: 202-723-8549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: