Organization
GRACE OUT LOUD THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANA-ALICIA FARRAR BROWN LICSW (CLINICAL SOCIAL WORKER)
(336) 926-7476
Entity
Organization
Contact information
Practice address
2150 SILVERSMITH CT, WOODBRIDGE, VA 22191-4123
(571) 412-1006
Mailing address
2150 SILVERSMITH CT, WOODBRIDGE, VA 22191-4123
(571) 412-1006
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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