Individual
PETER SUPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
4001 PRINCE WILLIAM PKWY STE 301, WOODBRIDGE, VA 22192-7667
(703) 688-8541
Mailing address
4307 32ND RD S, ARLINGTON, VA 22206-2000
(954) 328-5582
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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