Individual
MRS. KATIE FITE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, NCC, LPC
Contact information
Practice address
133 PARK ST NE, VIENNA, VA 22180-4602
(703) 281-4928
Mailing address
2404 N ROOSEVELT ST, ARLINGTON, VA 22207-1037
(843) 340-6402
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701005043
VA
Other
Enumeration date
06/01/2011
Last updated
06/01/2011
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