Individual
SEBLE WONGEL DEJENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 ROBERT FULTON DR STE 480, RESTON, VA 20191-5481
(703) 261-7000
(703) 860-1040
Mailing address
1801 ROBERT FULTON DR STE 480, RESTON, VA 20191-5481
(703) 261-7000
(703) 860-1040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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