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General NPI Number Information
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NPI Number | 1174117097
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Entity Type | Organization
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Legal Business Name | ALLOY CENTER FOR THERAPY
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 6218 GEORGIA AVE NW # 422
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City | WASHINGTON
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State | DC
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Zip | 20011-5125
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Country | US
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Telephone | 412-256-8654
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Fax |
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Provider Business Mailing Address
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Address Line | 8616 2ND AVE APT 225
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City | SILVER SPRING
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State | MD
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Zip | 20910-3792
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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 | OWNER
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Name | MRS. AUDRA JASMINE LEE
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Credential | LMFT
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Telephone | 412-657-8809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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