Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LC301654 | DC |
NPI | 1003083619 |
---|---|
Provider Name | Ms. Pauline Imbrigato |
First Address | Washington, DC 20005 |
Second Address | Washington, DC 20005-3406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 13/05/2008 |