Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 0810004256 | VA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY1000644 | DC |
NPI | 1063712024 |
---|---|
Provider Name | Dr. Angela Ayers Fletcher |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2010 |
Last Update Date | 25/10/2010 |