Individual
AVERILL ROBERTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(323) 522-2218
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(323) 522-2218
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0954324
NY
Other
Enumeration date
09/06/2017
Last updated
10/08/2023
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