Healthcare Provider Details

I. General information

NPI: 1760746143
Provider Name (Legal Business Name): DELIGHTFUL ALAKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 10/18/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 LAWRENCE ST NE
WASHINGTON DC
20017-3513
US

IV. Provider business mailing address

2608 OSAGE ST
ADELPHI MD
20783-1740
US

V. Phone/Fax

Practice location:
  • Phone: 202-635-5900
  • Fax:
Mailing address:
  • Phone: 202-717-5618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN1038694
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: