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General NPI Number Information
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NPI Number | 1841410271
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Entity Type | Individual
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Provider Name | CYNTHIA L ZORN-PETTIGREW L..C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12721 DARBY BROOK CT SUITE 102
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2408
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Country | US
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Telephone | 703-497-1771
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Fax | 703-497-1225
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Provider Business Mailing Address
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Address Line | 15061 GALAPAGOS PL
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City | WOODBRIDGE
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State | VA
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Zip | 22193-5842
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Country | US
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Telephone | 703-730-5227
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Fax | 703-368-8454
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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 | 0904002983
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License Number State | VA
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