Individual
SUSIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43803 MICHENER DR FL 2, ASHBURN, VA 20147-5807
(703) 863-8798
Mailing address
42135 PIEBALD SQ, ALDIE, VA 20105-5847
(703) 863-8798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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