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General NPI Number Information
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NPI Number | 1851107973
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Entity Type | Organization
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Legal Business Name | SUNNY DAZE CLINICAL SERVICES
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1101 WILSON BLVD, 6TH FL
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City | ARLINGTON
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State | VA
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Zip | 22209
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Country | US
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Telephone | 540-734-9260
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 W BROAD ST # 1079
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City | FALLS CHURCH
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State | VA
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Zip | 22046-2114
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Country | US
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Telephone | 540-734-9260
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | MISS SHAREE HASKINS
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Credential | LPC
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Telephone | 540-734-9260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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