Individual provider · Type 1 NPI

Divine F. Ticha

Psychiatric/Mental Health Nurse Practitioner · Washington, DC

NPI number 1750649554 Active

Practice location

1818 New York Ave NE, 117 Global Healthcare
Washington, DC 20002

Call (202) 480-0813 Map

Fax (202) 503-2363

Mailing address

13994 Baltimore Avenue, 13994 Baltimore Avenue Suite 102
Laurel, MD 20707

Specialties and licenses

Taxonomy	Code	License
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	R197963 (MD)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1750649554

Divine F. Ticha's National Provider Identifier is 1750649554, issued on Apr 30, 2012. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Washington, DC. The record was last updated on Dec 23, 2021.