Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1669126504 |
---|---|
Provider Name | Alexus Dominique Guy |
First Address | Washington, DC 20020-2931 |
Second Address | Washington, DC 20020-2931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2022 |
Last Update Date | 09/02/2022 |