Individual
DANIEL LAVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 CHURCH ST NE STE 212, VIENNA, VA 22180-4734
(571) 358-9765
Mailing address
11730 INDIAN RIDGE RD, RESTON, VA 20191-3522
(571) 230-4205
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012726
VA
Other
Enumeration date
06/19/2020
Last updated
05/20/2024
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