Healthcare Provider Details

I. General information

NPI: 1225155195
Provider Name (Legal Business Name): DALAL MUSA M.S.W., L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 PARK AVE SUITE B-3
FALLS CHURCH VA
22046-4312
US

IV. Provider business mailing address

6228 18TH RD N
ARLINGTON VA
22205-2020
US

V. Phone/Fax

Practice location:
  • Phone: 703-532-6220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904004940
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: