Individual
MR. MARK EARL SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
102 HERITAGE WAY, SE SUITE 302, LEESBURG, VA 20176-9813
(703) 771-5100
(703) 771-0320
Mailing address
102 HERITAGE WAY, SE SUITE 302, LEESBURG, VA 20176-2451
(703) 771-5100
(703) 771-0320
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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