Individual
EMILY FAGRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3172 CANTRELL LN, FAIRFAX, VA 22031-1909
(630) 908-0051
Mailing address
3172 CANTRELL LN, FAIRFAX, VA 22031-1909
(630) 908-0051
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012768
VA
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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