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General NPI Number Information
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NPI Number | 1558764134
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Entity Type | Organization
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Legal Business Name | NEUROPSYCH WELLNESS CENTER
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 3930 PENDER DR STE 350
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City | FAIRFAX
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State | VA
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Zip | 22030-0989
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Country | US
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Telephone | 703-865-8686
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 220403
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City | CHANTILLY
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State | VA
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Zip | 20153-0403
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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 | PRESIDENT/CEO
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Name | DR. ALOK KUMAR
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Credential | MD
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Telephone | 703-626-1420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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