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Individual

DR. VIRGINIA L REVERE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
9012 LINTON LN, ALEXANDRIA, VA 22308-2733
(703) 780-4872
Mailing address
9012 LINTON LN, ALEXANDRIA, VA 22308-2733
(703) 780-4872

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0810000939
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7703431
VA
Enumeration date
07/30/2006
Last updated
10/07/2011
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