Alexandria Csb
Community/Behavioral Health in Alexandria, VA. Organization (NPI-2).
NPI number1457413098
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1457413098
- Entity type
- Organization (NPI-2)
- Legal business name
- Alexandria Csb
- Organization subpart
- No
- Enumeration date
- Dec 13, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | 0810001425 | VA | Yes |
Practice location
720 N Saint Asaph StFourth Floor
Alexandria, VA 22314-1912
Phone 703-838-6400 · Fax 703-838-5070
Mailing address
4906 Sharon RdCamp Springs, MD 20748-2236
Authorized official
Mercedes Wilson Dallas
Clinical Psychologist
7038386400
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