Individual
MR. JOSE LUIS AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.,.
Contact information
Practice address
4946 SCHUYLER DR, ANNANDALE, VA 22003-5144
(571) 282-3903
(571) 282-3903
Mailing address
4946 SCHUYLER DR, ANNANDALE, VA 22003-5144
(571) 282-3903
(571) 282-3903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701002091
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194789545
—
VA
01
—
31390
AETNA
VA
01
—
541598045
APS
VA
01
—
7278061
AETNA
VA
01
—
83518
VALUE OPTIONS
VA
Enumeration date
04/13/2006
Last updated
05/19/2011
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