Individual
DANIETTA CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9677 MAIN ST, FAIRFAX, VA 22031-3763
(301) 767-1733
Mailing address
8209 PERIDOT DR UNIT 306, TYSONS CORNER, VA 22102-3968
(315) 399-6318
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701011580
VA
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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