is a Clinical in Fairfax, Virginia. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1093865271. The last update date is .
's current location address is 10420 Breckinridge Lane, Fairfax, Virginia. You can contact this provider via phone number 7036914968 and fax number 7036910187. The mailing address for is 10420 Breckinridge Lane, Fairfax, Virginia. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 10420 Breckinridge Lane, Fairfax, Virginia |
Phone Number | 7036914968 |
Fax Number | 7036910187 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1093865271 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 10420 Breckinridge Lane |
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City | Fairfax |
State | Virginia (VA) |
Post Code | 220303419 |
Phone Number | 7036914968 |
Fax Number | 7036910187 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 1041C0700X |
Licence No | 904000407 |
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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10410666 | CAQH UNIVERSAL CREDENTIAL |
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