Organization
GRACE PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA OLLIVER PA-C (PHYSICIAN ASSISTANT)
(505) 205-6397
Entity
Organization
Contact information
Practice address
8200 GREENSBORO DR STE 900, MC LEAN, VA 22102-4931
(703) 665-9613
Mailing address
8200 GREENSBORO DR STE 900, MC LEAN, VA 22102-4931
(703) 665-9613
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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