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General NPI Number Information
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NPI Number | 1427781491
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Entity Type | Individual
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Provider Name | KAYRAN TREIA LEE
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Gender | Female
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 10416 BURKE LAKE RD
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-1808
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Country | US
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Telephone | 703-297-8416
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Fax |
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Provider Business Mailing Address
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Address Line | 500 ABBERLY DR APT 302
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City | STAFFORD
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State | VA
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Zip | 22554-7346
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Country | US
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Telephone | 570-994-4645
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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 | 0701011188
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License Number State | VA
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