Individual
MARY C KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8624 APPLETON CT, ANNANDALE, VA 22003-3806
(703) 978-4590
(703) 978-4590
Mailing address
8624 APPLETON CT, ANNANDALE, VA 22003-3806
(703) 978-4590
(703) 978-4590
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
09040014
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8910910
—
VA
Enumeration date
07/04/2006
Last updated
01/08/2010
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