Organization
WILLOW TREE COUNELING AND EDUATIONAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA EVANS LPC (LICENSED PROFESIONAL COUNSELOR)
(703) 591-9600
Entity
Organization
Contact information
Practice address
10195 MAIN ST, SUITE N, FAIRFAX, VA 22031-3415
(703) 591-9600
(703) 591-9656
Mailing address
10195 MAIN ST, SUITE N, FAIRFAX, VA 22031-3415
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701004932
VA
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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