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General NPI Number Information
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NPI Number | 1245850510
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Entity Type | Organization
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Legal Business Name | SELAH SOLUTIONS, LLC
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 4660 KENMORE AVE STE 701
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1306
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Country | US
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Telephone | 571-354-0338
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Fax | 571-386-2663
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Provider Business Mailing Address
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Address Line | 13227 LENFANT DR
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-6539
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Country | US
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Telephone | 757-377-2361
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Fax | 571-386-2663
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JANICE PETTY
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Credential | LPC
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Telephone | 571-354-0338
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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 |
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License Number State |
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