Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | LG200001286 | DC |
NPI | 1003582826 |
---|---|
Provider Name | Weelay Gonyon |
First Address | Washington, DC 20001-4153 |
Second Address | Washington, DC 20001-4153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2021 |
Last Update Date | 20/08/2021 |