Individual
MARY BOLTON-OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
12359 SUNRISE VALLEY DR, SUITE 220, RESTON, VA 20191-3462
(301) 620-9762
Mailing address
4312 MARKWOOD LN, FAIRFAX, VA 22033-3638
(301) 260-9762
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003162
VA
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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