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NPI Code Detail

MEDICARE: MR. RAFEE AL-MANSUR LMFT

MEDICARE: MR. RAFEE AL-MANSUR LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0717001814VA

General Provider Information

NPI Number : 1245804707
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAFEE AL-MANSUR LMFT
Provider Business Mailing Address
First Line : 1364 BEVERLY RD STE 303
Second Line :
City : MC LEAN
State : VA
Zip : 22101-3644
Country : US
Telephone Number : 703-828-5189
Fax Number :
Provider Business Practice Location Address
First Line : 1364 BEVERLY RD STE 303
Second Line :
City : MC LEAN
State : VA
Zip : 22101-3644
Country : US
Telephone Number : 703-828-5189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2021
Last Update Date : 05/27/2021

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