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Individual

MS. JENNIFER LAUREN WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 777-0170
Mailing address
21641 RIDGETOP CIR, #105, STERLING, VA 20166-6597
(571) 258-3026
(571) 258-3032

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
08/30/2006
Last updated
11/14/2007
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