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General NPI Number Information
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NPI Number | 1912792631
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Entity Type | Individual
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Provider Name | RHIANNON TAKEMOTO-JENNINGS MED, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2025
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Last Update Date | 04/12/2025
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Provider Practice Location Address
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Address Line | 5641 BURKE CENTRE PKWY STE 118
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City | BURKE
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State | VA
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Zip | 22015-2261
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Country | US
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Telephone | 757-797-6465
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Fax | 844-269-1569
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Provider Business Mailing Address
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Address Line | 4157 MONUMENT HILL WAY APT 8309
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City | FAIRFAX
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State | VA
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Zip | 22030-8319
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Country | US
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Telephone | 540-293-2515
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Fax |
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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 | 0701014755
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License Number State | VA
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