Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1073179685 |
---|---|
Provider Name | Wubayehu Tegegne |
First Address | Washington, DC 20009-4773 |
Second Address | Washington, DC 20009-4773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2019 |
Last Update Date | 20/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000001 | 00001 (01) | DC |
000006 | (05) | DC |