Organization
RESTORATIVE THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONIA LEVY (MANAGING DIRECTOR)
(703) 884-7517
Entity
Organization
Contact information
Practice address
12020 SUNRISE VALLEY DR STE 100, RESTON, VA 20191-3429
(703) 884-7517
Mailing address
12020 SUNRISE VALLEY DR STE 100, RESTON, VA 20191-3429
(703) 884-7517
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LC4739
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0591041 00
—
MD
01
—
AK37
CARE FIRST
—
Enumeration date
08/19/2013
Last updated
09/28/2016
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