Healthcare Provider Details

I. General information

NPI: 1942857115
Provider Name (Legal Business Name): EMILY LOUISE PRYOR LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 WHEELER RD SE
WASHINGTON DC
20032-4129
US

IV. Provider business mailing address

1401 CHURCH ST NW APT 309
WASHINGTON DC
20005-2047
US

V. Phone/Fax

Practice location:
  • Phone: 214-356-6948
  • Fax:
Mailing address:
  • Phone: 214-356-6948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberLG50082911
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: