Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LGP8491 | MD |
NPI | 1003312190 |
---|---|
Provider Name | Dionna Nichele Casey |
First Address | Greenbelt, MD 20770-3523 |
Second Address | Greenbelt, MD 20770-3504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2018 |
Last Update Date | 06/04/2018 |