Individual
REBECCA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 S WHITING ST STE 600, ALEXANDRIA, VA 22304-7121
(571) 257-8634
Mailing address
21049 ROAMING SHORES TER, ASHBURN, VA 20147-3208
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/08/2021
Last updated
07/13/2022
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