Individual
MICHELLE AYRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
8415 ARLINGTON BLVD, FAIRFAX, VA 22031-4601
(703) 208-1500
Mailing address
42 WIRTH CT, MADISON, WI 53704
(608) 556-8432
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
893-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245786680
—
WI
Enumeration date
02/20/2007
Last updated
09/03/2021
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