MEDICARE: THE WOMEN'S COLLECTIVE

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
1	251B00000X	Case Management Agency	MD035068	DC
2	251S00000X	Community/Behavioral Health Agency	MD035068	DC

General Provider Information

NPI Number	:	1578927612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WOMEN'S COLLECTIVE

Provider Business Mailing Address
First Line	:	1331 RHODE ISLAND AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-3706
Country	:	US
Telephone Number	:	202-483-7003
Fax Number	:

Provider Business Practice Location Address
First Line	:	1331 RHODE ISLAND AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-3706
Country	:	US
Telephone Number	:	202-483-7003
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/EXECUTIVE DIRECTOR
Name	:	MS. PATRICIA L NALLS
Credential	:
Telephone Number	:	202-483-7003

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	04/05/2016

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Directions to “THE WOMEN'S COLLECTIVE ” Practice Location

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