Healthcare Provider Details

I. General information

NPI: 1417898263
Provider Name (Legal Business Name): MIRIAM SALEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7918 JONES BRANCH DR
MC LEAN VA
22102-3337
US

IV. Provider business mailing address

7918 JONES BRANCH DR
MC LEAN VA
22102-3337
US

V. Phone/Fax

Practice location:
  • Phone: 703-260-9978
  • Fax:
Mailing address:
  • Phone: 703-260-9978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704015585
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: