Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | LC10960 | MD |
Y | 101YP2500X | Professional Counselor | LGP9095 | MD |
NPI | 1003374133 |
---|---|
Provider Name | Tasha Nate Allen |
First Address | Baltimore, MD 21206-2932 |
Second Address | Baltimore, MD 21218-5909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2019 |
Last Update Date | 28/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38-3876389 | (05) | MD |