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General NPI Number Information
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NPI Number | 1861592024
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Entity Type | Individual
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Provider Name | SHERI A. MITSCHELEN M.S.W., R.P.T.-S
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3607 CHAIN BRIDGE RD STE A
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City | FAIRFAX
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State | VA
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Zip | 22030-3242
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Country | US
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Telephone | 703-380-9045
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Fax | 703-818-2671
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Provider Business Mailing Address
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Address Line | 3607 CHAIN BRIDGE RD STE A
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City | FAIRFAX
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State | VA
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Zip | 22030-3242
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Country | US
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Telephone | 703-380-9045
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Fax | 703-818-2671
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904001977
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License Number State | VA
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