Individual
MS. M.CLAIRE H DUTROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,LMFT,CSAC
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710001126
VA
101YM0800X
Mental Health Counselor
Primary
0701002668
VA
106H00000X
Marriage & Family Therapist
0717000694
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945247
—
VA
05
—
004978277
—
VA
01
—
210245
BLUE CROSS BLUE SHIELD
VA
Enumeration date
10/24/2006
Last updated
05/19/2009
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