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General NPI Number Information
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NPI Number | 1891010328
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Entity Type | Organization
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Legal Business Name | GIL CENTER FOR HEALING AND PLAY
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Dates
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Enumeration Date | 03/27/2010
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Last Update Date | 03/27/2010
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Provider Practice Location Address
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Address Line | 8626 LEE HWY SUITE 200
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City | FAIRFAX
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State | VA
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Zip | 22031-2135
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Country | US
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Telephone | 703-979-1415
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Fax |
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Provider Business Mailing Address
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Address Line | 8626 LEE HWY SUITE 200
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City | FAIRFAX
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State | VA
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Zip | 22031-2135
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Country | US
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Telephone | 703-979-1415
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ELIANA GIL
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Credential | PH.D.
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Telephone | 703-979-1415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717000560
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License Number State | VA
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