Healthcare Provider Details

I. General information

NPI: 1861302119
Provider Name (Legal Business Name): MRS. ANA ISABEL FERMIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44927 GEORGE WASHINGTON BLVD STE 255
ASHBURN VA
20147-4294
US

IV. Provider business mailing address

857 FERNDALE TER NE
LEESBURG VA
20176-4872
US

V. Phone/Fax

Practice location:
  • Phone: 571-650-0303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704019440
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: