Old Town Therapy & Wellness Center, Llc | |
6119 Holly Tree Dr Alexandria VA 22310-2215 | |
(703) 577-5550 | |
Not Available |
Full Name | Old Town Therapy & Wellness Center, Llc |
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Speciality | Social Worker - Clinical |
Location | 6119 Holly Tree Dr, Alexandria, Virginia |
Authorized Official Name and Position | Susan Ross (DIRECTOR) |
Authorized Official Contact | 7035775550 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Old Town Therapy & Wellness Center, Llc 817 King St Ste 203a Alexandria VA 22314-3016 Ph: () - | Old Town Therapy & Wellness Center, Llc 6119 Holly Tree Dr Alexandria VA 22310-2215 Ph: (703) 577-5550 |
NPI Number | 1760723423 |
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Provider Enumeration Date | 03/06/2013 |
Last Update Date | 03/06/2013 |
Identifier | Type | State | Issuer |
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1760723423 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 0904005550 (Virginia) | Primary |
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