Doctor Name: | DR. FRED WASHINGTON |
NPI Number: | 1821393570 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 4431 |
Business Practice Address: | 131 W 1st St Palisade, CO - 815269714 |
Business Phone Number: | 9704649381 |
Business Fax Number: | |
Mailing Address: | 131 W 1st St, PALISADE |
State: | CO |
Postal Code: | 815269714 |
Phone Number: | 9704649381 |
Fax Number: | |
NPI Enumeration Date: | 01/11/2011 |
NPI Last Update Date: | 01/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |