Organization
PIMMIT COUNSELING & WELLNESS CLINIC PLLC
Active
Other names
Pimmit Counseling & Wellness Clinic ABA Program
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRZAD N/A POORSHAGHAGHI ED.D (DIRECTOR)
(703) 556-4888
Entity
Organization
Contact information
Practice address
2235 CEDAR LN STE 102, VIENNA, VA 22182-5247
(703) 556-4888
Mailing address
2235 CEDAR LN STE 102, VIENNA, VA 22182-5247
(703) 556-4888
(703) 556-7774
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5411165
—
VA
Enumeration date
05/14/2018
Last updated
10/05/2020
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