Organization
BLUE BOX PSYCHOTHERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHA GRAY LPC (OWNER)
(773) 531-8390
Entity
Organization
Contact information
Practice address
2121 EISENHOWER AVE STE 300, ALEXANDRIA, VA 22314-4688
(571) 551-6839
Mailing address
7982 HIDDEN BRIDGE DR, SPRINGFIELD, VA 22153-3206
(773) 531-8390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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