Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LC50078286 | DC |
NPI | 1003141532 |
---|---|
Provider Name | Mr. Brandon Joseph Stratford |
First Address | Washington, DC 20009-6001 |
Second Address | Washington, DC 20009-4506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2009 |
Last Update Date | 16/10/2009 |