Healthcare Provider Details

I. General information

NPI: 1649123720
Provider Name (Legal Business Name): MADELINE DOLORES DRYFOOS RIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N QUINCY ST STE 601
ARLINGTON VA
22203-1729
US

IV. Provider business mailing address

801 N QUINCY ST STE 601
ARLINGTON VA
22203-1729
US

V. Phone/Fax

Practice location:
  • Phone: 667-220-8067
  • Fax:
Mailing address:
  • Phone: 667-220-8067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704018948
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: