| Fairfax Child And Family Therapy Llc | |
|
7019 Evergreen Ct # 6b Annandale VA 22003 | |
| (202) 810-2174 | |
| Not Available |
| Full Name | Fairfax Child And Family Therapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7019 Evergreen Ct # 6b, Annandale, Virginia |
| Authorized Official Name and Position | Jee Young Suk (COUNSELOR) |
| Authorized Official Contact | 2028102174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Child And Family Therapy Llc 7019 Evergreen Ct # 6b Annandale VA 22003-3227 Ph: (202) 810-2174 | Fairfax Child And Family Therapy Llc 7019 Evergreen Ct # 6b Annandale VA 22003 Ph: (202) 810-2174 |
| NPI Number | 1689266140 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 09/28/2022 |
| Certification Date | 09/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689266140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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