Individual
CHRISTINE VANDERTOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
412 TEAROSE PL SW, LEESBURG, VA 20175-2522
(818) 416-5979
(818) 584-8878
Mailing address
PO BOX 2902, LEESBURG, VA 20177-7917
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001469
VA
106H00000X
Marriage & Family Therapist
49416
CA
Other
Enumeration date
02/15/2011
Last updated
03/04/2020
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