Individual
MRS. JACQUELINE BRODY LAURENZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8245 BOONE BLVD STE 630, VIENNA, VA 22182-3894
(412) 491-7140
Mailing address
40996 BLOSSOM GLADE DR, ALDIE, VA 20105-5827
(412) 491-7140
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704016693
VA
101YP2500X
Professional Counselor
0704016693
VA
Other
Enumeration date
02/05/2024
Last updated
03/05/2025
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