| Sage House Art Therapy, Pllc | |
|
11250 Roger Bacon Dr Bldg 10 Reston VA 20190-5219 | |
| (703) 483-9442 | |
| Not Available |
| Full Name | Sage House Art Therapy, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11250 Roger Bacon Dr Bldg 10, Reston, Virginia |
| Authorized Official Name and Position | Kathryn Tedeschi (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7034839442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage House Art Therapy, Pllc 11250 Roger Bacon Dr Bldg 10 Reston VA 20190-5219 Ph: () - | Sage House Art Therapy, Pllc 11250 Roger Bacon Dr Bldg 10 Reston VA 20190-5219 Ph: (703) 483-9442 |
| NPI Number | 1467071142 |
|---|---|
| Provider Enumeration Date | 04/13/2020 |
| Last Update Date | 04/13/2020 |
| Certification Date | 04/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467071142 | NPI | - | NPPES |
| 0701007801 | Other | VA | VIRGINIA BOARD OF COUNSELING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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