Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 25960 | DC |
NPI | 1215369657 |
---|---|
Provider Name | Dr. Pamela Teresa Mccollum-Butler |
First Address | Fort Washington, MD 20744-3957 |
Second Address | Washington, DC 20003-2883 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2013 |
Last Update Date | 08/08/2013 |