Healthcare Provider Details

I. General information

NPI: 1912404070
Provider Name (Legal Business Name): THERAPEUTIC EMPLOYEE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 N SAINT ASAPH ST STE G
ALEXANDRIA VA
22314-3110
US

IV. Provider business mailing address

6192 TROTTERS GLEN DR
HUGHESVILLE MD
20637-2876
US

V. Phone/Fax

Practice location:
  • Phone: 703-857-5354
  • Fax: 571-601-4607
Mailing address:
  • Phone: 318-791-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEITRA L FANT
Title or Position: OWNER/CEO
Credential: LCPC
Phone: 703-857-5354