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General NPI Number Information
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NPI Number | 1699103622
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Entity Type | Organization
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Legal Business Name | DCPS
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 5504 TROUT RUN RD
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City | CLINTON
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State | MD
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Zip | 20735
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Country | US
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Telephone | 202-673-7385
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Fax |
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Provider Business Mailing Address
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Address Line | 5504 TROUT RUN RD
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City | CLINTON
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State | MD
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Zip | 20735-1568
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Country | US
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Telephone | 202-673-7385
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. NINA MONIQUE HARRISON
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Credential | LGSW
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Telephone | 202-673-7385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LG50078138
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License Number State | DC
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