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General NPI Number Information
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NPI Number | 1588349195
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Entity Type | Individual
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Provider Name | KARA SHEEHAN ATR, RESIDENT
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 10513 JUDICIAL DR STE 301
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City | FAIRFAX
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State | VA
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Zip | 22030-7528
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Country | US
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Telephone | 703-966-5173
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Fax |
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Provider Business Mailing Address
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Address Line | 666 GATEWAY DR SE UNIT 502
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City | LEESBURG
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State | VA
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Zip | 20175-4069
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Country | US
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Telephone | 703-727-3331
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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 | 0704014210
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License Number State | VA
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