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General NPI Number Information
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NPI Number | 1245756998
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Entity Type | Individual
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Provider Name | HIWOT GIZACHEW
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Gender | Female
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 8221 WILLOW OAKS CO DR STE 4-430
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City | FAIRFAX
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State | VA
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Zip | 22031-4512
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Country | US
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Telephone | 703-289-4995
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Fax |
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Provider Business Mailing Address
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Address Line | 8221 WILLOW OAKS CORPORATE DR STE 4-430
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City | FAIRFAX
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State | VA
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Zip | 22031-4512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180010688
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License Number State | IL
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