Individual
MAYA MARTINOVA RADOSLAVOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
ELLIE MENTAL HEALTH, 10301 DEMOCRACY LANE, SUITE 302, FAIRFAX, VA 22030
(571) 223-7588
Mailing address
4600 S FOUR MILE RUN DR APT 739, ARLINGTON, VA 22204-3564
(571) 341-0465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704016703
VA
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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