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NPI Code Detail

MEDICARE: MISS ALICIA RENEE WASHINGTON RSW

MEDICARE: MISS ALICIA RENEE WASHINGTON RSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor12704LA

General Provider Information

NPI Number : 1134677172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALICIA RENEE WASHINGTON RSW
Provider Business Mailing Address
First Line : 5174 SAINT ANTHONY AVE
Second Line : APT D
City : NEW ORLEANS
State : LA
Zip : 70122-4056
Country : US
Telephone Number : 504-333-9230
Fax Number :
Provider Business Practice Location Address
First Line : 5174 SAINT ANTHONY AVE
Second Line : APT D
City : NEW ORLEANS
State : LA
Zip : 70122-4056
Country : US
Telephone Number : 504-333-9230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2016
Last Update Date : 09/20/2016

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Directions to “ MISS ALICIA RENEE WASHINGTON RSW” Practice Location

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