Individual
MRS. JANENE PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
8500 EXECUTIVE PARK AVE STE 204, FAIRFAX, VA 22031-2253
(505) 977-9487
Mailing address
10623 BATTALION LANDING CT, BURKE, VA 22015-2517
(505) 977-9487
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0165071
NM
Other
Enumeration date
12/12/2013
Last updated
07/30/2014
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