Healthcare Provider Details

I. General information

NPI: 1285393454
Provider Name (Legal Business Name): TAQUANDA FRAMAE MULDROW-DIXON LGMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAQUANDA FRAMAE DIXON

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10665 STANHAVEN PL # 3118
WHITE PLAINS MD
20695-3055
US

IV. Provider business mailing address

8120 KNIGHTSBRIDGE ST
WHITE PLAINS MD
20695-3417
US

V. Phone/Fax

Practice location:
  • Phone: 240-222-3225
  • Fax:
Mailing address:
  • Phone: 870-397-1340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLGM863
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: