Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003325515 |
---|---|
Provider Name | Nicole Courtney Twaalfhoven |
First Address | Washington, DC 20002-4818 |
Second Address | Silver Spring, MD 20910-3653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2017 |
Last Update Date | 20/09/2021 |