| Evidence Based Treatment Collaborative | |
|
4000 Legato Rd Fl 11 Fairfax VA 22033-2892 | |
| (571) 206-1747 | |
| Not Available |
| Full Name | Evidence Based Treatment Collaborative |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4000 Legato Rd Fl 11, Fairfax, Virginia |
| Authorized Official Name and Position | Joanna Marino (CEO) |
| Authorized Official Contact | 5714771611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evidence Based Treatment Collaborative 4000 Legato Rd Fl 11 Fairfax VA 22033-2892 Ph: () - | Evidence Based Treatment Collaborative 4000 Legato Rd Fl 11 Fairfax VA 22033-2892 Ph: (571) 206-1747 |
| NPI Number | 1922858794 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922858794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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