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General NPI Number Information
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NPI Number | 1316040306
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Entity Type | Individual
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Provider Name | WENDY WAHL MOORE LPC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 2800 S SHIRLINGTON RD STE 350
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City | ARLINGTON
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State | VA
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Zip | 22206-3617
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Country | US
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Telephone | 703-379-9311
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Fax |
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Provider Business Mailing Address
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Address Line | 7611 RANGE RD
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City | ALEXANDRIA
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State | VA
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Zip | 22306-2425
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Country | US
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Telephone | 410-703-2543
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LCPC 1603
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License Number State | MD
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