| Amelville Holdings | |
|
4094 Majestic Ln Unit 315 Fairfax VA 22033-2104 | |
| (860) 796-4553 | |
| Not Available |
| Full Name | Amelville Holdings |
|---|---|
| Speciality | Psychologist |
| Location | 4094 Majestic Ln Unit 315, Fairfax, Virginia |
| Authorized Official Name and Position | Alexis Melville (OWNER) |
| Authorized Official Contact | 8607964553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amelville Holdings 4094 Majestic Ln Unit 315 Fairfax VA 22033-2104 Ph: () - | Amelville Holdings 4094 Majestic Ln Unit 315 Fairfax VA 22033-2104 Ph: (860) 796-4553 |
| NPI Number | 1659838134 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 02/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659838134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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