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General NPI Number Information
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NPI Number | 1386248912
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Entity Type | Individual
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Provider Name | DYANNA CITIZEN MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 6408 GROVEDALE DR
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2595
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Country | US
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Telephone | 410-893-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 4445 CORPORATION LN STE 264
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3262
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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 | PRC14737
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701010132
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License Number State | VA
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