Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1275075962 |
---|---|
Provider Name | Mrs. Mechelle Armstead-Pharr |
First Address | Ashton, MD 20861-0339 |
Second Address | Silver Spring, MD 20905-3913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2016 |
Last Update Date | 10/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
414259400 | (05) | MD |