Healthcare Provider Details

I. General information

NPI: 1467190801
Provider Name (Legal Business Name): DISTRICT THERAPY HUB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 P ST NW STE 740
WASHINGTON DC
20036-6972
US

IV. Provider business mailing address

2000 P ST NW STE 740
WASHINGTON DC
20036-6972
US

V. Phone/Fax

Practice location:
  • Phone: 202-851-2751
  • Fax: 202-355-6713
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DIANA WALL
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential:
Phone: 202-851-2751