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General NPI Number Information
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NPI Number | 1912056615
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Entity Type | Individual
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Provider Name | MS. MALINDA DENNIS
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 720 N SAINT ASAPH ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1912
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Country | US
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Telephone | 703-838-4455
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Fax | 703-838-5070
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Provider Business Mailing Address
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Address Line | 3800 POWELL LN APT #429
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3687
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Country | US
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Telephone | 703-838-4455
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Fax | 703-838-5070
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701003389
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC1262
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License Number State | DC
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