OrganizationActive
Creative Change Dynamic Therapy LLC
NPI 1245020833 · Community/Behavioral Health Agency · Washington, DC
Provider details
- NPI number
- 1245020833
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Authorized official
- Domonique Malloy, Owner
Practice location
2825 Robinson Place, Se # 102
Washington, DC 20020
Phone: (240) 528-3406
Mailing address
Po Box 2003
Greenbelt, MD 20768-2003
Registry dates
- Enumerated
- 2025-05-08
- Last updated
- 2025-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.