Organization
SOUTH LAKES COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REANNA NOOR (OWNER)
(703) 200-9300
Entity
Organization
Contact information
Practice address
2229 DOUBLE EAGLE CT, RESTON, VA 20191-2401
(703) 200-9300
Mailing address
2229 DOUBLE EAGLE CT, RESTON, VA 20191-2401
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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