Healthcare Provider Details

I. General information

NPI: 1639601255
Provider Name (Legal Business Name): VILMA NADAL LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2017
Last Update Date: 04/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 CONNECTICUT AVE NW
WASHINGTON DC
20008-1158
US

IV. Provider business mailing address

6024 BERKSHIRE DR
BETHESDA MD
20814-2252
US

V. Phone/Fax

Practice location:
  • Phone: 202-204-5030
  • Fax:
Mailing address:
  • Phone: 202-255-0971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC300083
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: