Individual
MRS. AUDRA VICTORIA PHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LICSW
Contact information
Practice address
3340 WOODBURN RD, ANNANDALE, VA 22003-1202
(703) 573-0523
(703) 280-9518
Mailing address
3340 WOODBURN RD, ANNANDALE, VA 22003-1202
(703) 573-0523
(703) 280-9518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006899
VA
1041C0700X
Clinical Social Worker
LG50078551
DC
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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