Individual
MR. CHARLES BRENT LASLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8641 BREEDEN AVE, SUITE 200, MANASSAS, VA 20110-8431
(703) 392-6850
(703) 392-6852
Mailing address
2510 DEEPFORD DR, WOODBRIDGE, VA 22192-1607
(703) 201-6696
(703) 492-6490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002368
VA
Other
Enumeration date
09/26/2006
Last updated
07/09/2007
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