Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD039670 | DC |
NPI | 1013176924 |
---|---|
Provider Name | Lekeisha Terrell |
First Address | Washington, DC 20032-5406 |
Second Address | Washington, DC 20032-5406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 23/08/2011 |