Individual
MAXINE IIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RESIDENT IN COUNSELI
Contact information
Practice address
950 N WASHINGTON ST STE 322, ALEXANDRIA, VA 22314-6498
(540) 845-6940
Mailing address
950 N WASHINGTON ST STE 322, ALEXANDRIA, VA 22314-6498
(540) 845-6940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704015316
VA
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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