Individual
MS. STELLA A DEAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Mailing address
14728 BARKSDALE ST, WOODBRIDGE, VA 22193-1704
(703) 792-7848
(709) 792-5699
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0904001388
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04978277
—
VA
01
—
210245
BLUE CROSS BLUE SHIELD
VA
Enumeration date
10/17/2006
Last updated
01/17/2008
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