Individual
MR. BARRY DALE MCNINCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS COUNSELING
Contact information
Practice address
10513 JUDICIAL DR STE 201, FAIRFAX, VA 22030-7528
(703) 936-8066
Mailing address
10513 JUDICIAL DR STE 201, FAIRFAX, VA 22030-7528
(703) 936-8066
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704013860
VA
101Y00000X
Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704013860
VA LICENSE
VA
Enumeration date
05/29/2021
Last updated
05/29/2021
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