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General NPI Number Information
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NPI Number | 1548939374
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Entity Type | Organization
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Legal Business Name | MARRIAGE AND FAMILY THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 17521 TRIPOLI BLVD
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City | DUMFRIES
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State | VA
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Zip | 22026-2239
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Country | US
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Telephone | 703-615-2891
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Fax |
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Provider Business Mailing Address
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Address Line | 13614 HIDDEN CREEK RD
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City | MANASSAS
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State | VA
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Zip | 20112-5577
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Country | US
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Telephone | 703-615-2891
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Fax |
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Authorized Official
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Title or Position | MARRIAGE & FAMILY THERAPIST
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Name | MRS. LAURIE LYNNE WILSON
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Credential | LMFT
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Telephone | 703-615-2891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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