Provider Demographics
NPI:1922725837
Name:LEE, DEBRA APRIL LATOAK (MSN PMHN APRN BC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:APRIL LATOAK
Last Name:LEE
Suffix:
Gender:F
Credentials:MSN PMHN APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12774 WISTERIA DR UNIT 2724
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-7635
Mailing Address - Country:US
Mailing Address - Phone:301-355-9569
Mailing Address - Fax:
Practice Address - Street 1:19403 BUCKINGHAM WAY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-4665
Practice Address - Country:US
Practice Address - Phone:301-355-9569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185578363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health