Individual
KIMBERLY VAN LANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 383-8427
Mailing address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006623
VA
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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