Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 67425 | TX |
NPI | 1003156597 |
---|---|
Provider Name | Nakeisha Quian Washington |
First Address | Humble, TX 77346-2739 |
Second Address | Humble, TX 77346-2739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2013 |
Last Update Date | 21/02/2013 |