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General NPI Number Information
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NPI Number | 1225913908
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Entity Type | Individual
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Provider Name | ISIDORA TERESITA ECHENIQUE BERTON
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 4530 WISCONSIN AVE NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20016-4606
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Country | US
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Telephone | 202-536-4414
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 CONNECTICUT AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20008-4530
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGPC200001782
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License Number State | DC
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