| Branding Athletes As Legendary Leaders | |
|
6617 13th Pl Nw Washington DC 20012-2309 | |
| (240) 643-3894 | |
| Not Available |
| Full Name | Branding Athletes As Legendary Leaders |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6617 13th Pl Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | Shawntese Charles (CEO) |
| Authorized Official Contact | 2406433894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Branding Athletes As Legendary Leaders 6617 13th Pl Nw Washington DC 20012-2309 Ph: (240) 643-3894 | Branding Athletes As Legendary Leaders 6617 13th Pl Nw Washington DC 20012-2309 Ph: (240) 643-3894 |
| NPI Number | 1427716299 |
|---|---|
| Provider Enumeration Date | 11/29/2021 |
| Last Update Date | 11/29/2021 |
| Certification Date | 11/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427716299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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