Individual
MRS. ELLEN GOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPS, BCDMT, LPC
Contact information
Practice address
11726 LARIAT LANEE, OAKTON, VA 22124
(703) 860-8188
Mailing address
11726 LARIAT LN, OAKTON, VA 22124-2323
(703) 860-8188
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00234600
NJ
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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