Individual
KACEYA T SISTARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 WASHINGTON BLVD FL 3, ARLINGTON, VA 22204-5717
(703) 228-1500
Mailing address
2100 WASHINGTON BLVD FL 4, ARLINGTON, VA 22204-5717
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701012823
VA
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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