Healthcare Provider Details

I. General information

NPI: 1821881152
Provider Name (Legal Business Name): AMANDA CONFAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 CHAIN BRIDGE RD STE C&D
FAIRFAX VA
22030-3246
US

IV. Provider business mailing address

10 LITTLE FIELD DR
FREDERICKSBURG VA
22405-1835
US

V. Phone/Fax

Practice location:
  • Phone: 703-380-9045
  • Fax:
Mailing address:
  • Phone: 540-642-7169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: