| Transformation In Color, Llc | |
|
4200 Forbes Blvd Ste 208 Lanham MD 20706-4823 | |
| (240) 709-6557 | |
| Not Available |
| Full Name | Transformation In Color, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4200 Forbes Blvd Ste 208, Lanham, Maryland |
| Authorized Official Name and Position | Da'keisha Molique Johnson (COUNSELOR) |
| Authorized Official Contact | 2407096557 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformation In Color, Llc Po Box 1519 Temple Hills MD 20757-1519 Ph: (240) 709-6557 | Transformation In Color, Llc 4200 Forbes Blvd Ste 208 Lanham MD 20706-4823 Ph: (240) 709-6557 |
| NPI Number | 1780351890 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 02/10/2023 |
| Certification Date | 02/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780351890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 103TF0200X | Psychologist - Forensic | (* (Not Available)) | Secondary |
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