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General NPI Number Information
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NPI Number | 1518770031
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Entity Type | Organization
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Legal Business Name | ALIBI MENTAL HEALTH CARE PLLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 800 NEW JERSEY AVE SE APT 737
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City | WASHINGTON
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State | DC
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Zip | 20003-3995
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Country | US
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Telephone | 202-681-6950
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 N ST NW STE 1
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City | WASHINGTON
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State | DC
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Zip | 20036-2827
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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/PMHNP
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Name | JESSICA PUDLO
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Credential | CRNP
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Telephone | 202-681-6950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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