Healthcare Provider Details

I. General information

NPI: 1316895303
Provider Name (Legal Business Name): MILAN POINDEXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 FRIENDSHIP BLVD STE 590
CHEVY CHASE MD
20815-7310
US

IV. Provider business mailing address

177 WILSHIRE DR APT 723
TROY MI
48084-1787
US

V. Phone/Fax

Practice location:
  • Phone: 240-945-2390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301019751
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: