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General NPI Number Information
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NPI Number | 1699182097
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Entity Type | Organization
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Legal Business Name | THERAPY AND LIFE COUNSELING
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 14377 HEREFORD RD
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City | WOODBRIDGE
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State | VA
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Zip | 22193-2107
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Country | US
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Telephone | 703-878-6670
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Fax | 703-878-3370
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Provider Business Mailing Address
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Address Line | 14377 HEREFORD RD
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City | WOODBRIDGE
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State | VA
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Zip | 22193-2107
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Country | US
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Telephone | 703-878-6670
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Fax | 703-878-3370
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. MICHELE LYNN ZWEIBAHMER
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Credential | LPC
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Telephone | 703-878-6670
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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 | 0701004238
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License Number State | VA
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