Individual
ERIKA PTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7440 HERITAGE VILLAGE PLZ STE 102, GAINESVILLE, VA 20155-3081
(703) 994-2828
Mailing address
13524 WANSTEADT PL, BRISTOW, VA 20136-5729
(703) 994-2828
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701012887
VA
101YM0800X
Mental Health Counselor
0701012887
VA
101YP2500X
Professional Counselor
Primary
0701012887
VA
101YS0200X
School Counselor
—
VA
Other
Enumeration date
11/02/2023
Last updated
12/13/2023
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