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General NPI Number Information
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NPI Number | 1679392674
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Entity Type | Individual
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Provider Name | MARIAH LU ALLEN LPC
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 2100 WASHINGTON BLVD FL 3
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City | ARLINGTON
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State | VA
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Zip | 22204-5717
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Country | US
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Telephone | 703-228-1099
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Fax |
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Provider Business Mailing Address
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Address Line | 11310 LINKS CT
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City | RESTON
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State | VA
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Zip | 20190-4805
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Country | US
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Telephone | 801-791-8157
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701013884
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License Number State | VA
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