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General NPI Number Information
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NPI Number | 1598058034
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Entity Type | Individual
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Provider Name | JOSEPHINE DYKES STATON LPC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 20411 LINDOS CT N/A
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City | MONTGOMERY VILLAGE
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State | MD
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Zip | 20886-4367
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Country | US
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Telephone | 202-581-2445
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Fax | 202-581-2459
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Provider Business Mailing Address
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Address Line | 20411 LINDOS CT N/A
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City | MONTGOMERY VILLAGE
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State | MD
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Zip | 20886-4367
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Country | US
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Telephone | 202-581-2445
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Fax | 202-581-2459
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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 | PRC236
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License Number State | DC
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