Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSYA00233 | DC |
Y | 103T00000X | Psychologist | PSYA00233 | DC |
NPI | 1013599810 |
---|---|
Provider Name | Akia T Wade |
First Address | Hyattsville, MD 20785-2701 |
Second Address | Washington, DC 20008-5702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2021 |
Last Update Date | 22/04/2021 |