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Organization
SAGE HOUSE ART THERAPY, PLLC
Active
Organization
SAGE HOUSE ART THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN TEDESCHI ATR-BC, LPC (CLINICAL DIRECTOR)
(703) 483-9442
Entity
Organization
Contact information
Practice address
11250 ROGER BACON DR BLDG 10, RESTON, VA 20190-5219
(703) 483-9442
Mailing address
11250 ROGER BACON DR BLDG 10, RESTON, VA 20190-5219
(703) 483-9442
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701007801
BOARD OF COUNSELING
VA
Enumeration date
03/31/2020
Last updated
03/31/2020
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