Individual
HEATHER WYDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 EISENHOWER AVE STE 103, ALEXANDRIA, VA 22314-5305
(540) 845-6940
Mailing address
5651 MORELAND ST NW, WASHINGTON, DC 20015-1115
(202) 669-6163
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/27/2024
Last updated
01/28/2026
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