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General NPI Number Information
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NPI Number | 1154063972
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Entity Type | Individual
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Provider Name | YAMILETH NOLASCO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 102 IRVING ST NW FL 1
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City | WASHINGTON
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State | DC
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Zip | 20010-2921
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Country | US
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Telephone | 202-877-1822
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 41032
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City | WASHINGTON
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State | DC
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Zip | 20018-0432
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29372
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 210002131
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License Number State | DC
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