Individual
MRS. LETICIA SALO ISIDRO-CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC-MFT, LADC
Contact information
Practice address
9300 DEWITT LOOP, RIVER PAVILION 2ND FLOOR R2.301, FORT BELVOIR COMMUNITY HOSPITAL, FORT BELVOIR, VA 22060
(571) 231-1292
(571) 231-1283
Mailing address
8906 BLUFFWOOD LN, FORT WASHINGTON, MD 20744-6764
(571) 231-1292
(571) 231-3224
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00082200
NJ
101YM0800X
Mental Health Counselor
37PC00078400
NJ
106H00000X
Marriage & Family Therapist
Primary
37PC00078400
NJ
Other
Enumeration date
02/15/2007
Last updated
06/10/2015
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