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General NPI Number Information
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NPI Number | 1699595280
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Entity Type | Organization
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Legal Business Name | HEART HELD THERAPY LLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 12001 SUNRISE VALLEY DR
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City | RESTON
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State | VA
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Zip | 20191-3450
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Country | US
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Telephone | 703-584-5186
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Fax |
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Provider Business Mailing Address
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Address Line | 11089 SAFFOLD WAY
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City | RESTON
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State | VA
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Zip | 20190-3815
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Country | US
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Telephone | 919-410-0412
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS LAURA WAKEFIELD
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Credential | LPC
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Telephone | 919-410-0412
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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 |
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License Number State |
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