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General NPI Number Information
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NPI Number | 1174791792
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Entity Type | Individual
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Provider Name | SCHWANNA Y COCKERHAM-QUALLS LPC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2008
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Last Update Date | 02/17/2008
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Provider Practice Location Address
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Address Line | 1234 19TH ST NW STE 230
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City | WASHINGTON
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State | DC
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Zip | 20036-2448
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Country | US
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Telephone | 202-413-6240
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Fax |
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Provider Business Mailing Address
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Address Line | 3836 TREMAYNE TER
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City | SILVER SPRING
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State | MD
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Zip | 20906-2660
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Country | US
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Telephone | 240-669-8327
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC13768
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License Number State | DC
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