Individual
MARA WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10560 MAIN ST STE 410, FAIRFAX, VA 22030-7174
(703) 352-9040
Mailing address
10560 MAIN ST STE 410, FAIRFAX, VA 22030-7174
(703) 352-9040
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701009953
VA
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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