Organization
GRACE COUNSELING & MEDIATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOTTIE GRACE OLSON-DAVIDSON PH.D. (OWNER)
(703) 910-7529
Entity
Organization
Contact information
Practice address
2875 CHEVOIT HILL CT, WOODBRIDGE, VA 22191
(703) 910-7529
(703) 910-7555
Mailing address
4222 FORTUNA CENTER PLZ STE 192, DUMFRIES, VA 22025-1515
(703) 910-7529
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701005309
VA
Other
Enumeration date
08/13/2008
Last updated
10/09/2024
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