Organization
EZRA, NEHEMIAH AND SOLOMON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FAY MARSHALL LESANE LCSW (CLINICAL DIRECTOR)
(703) 221-6600
Entity
Organization
Contact information
Practice address
3904 LANSING CT, DUMFRIES, VA 22026-2460
(703) 221-6600
(703) 221-4466
Mailing address
PO BOX 1134, DUMFRIES, VA 22026-9134
(703) 221-6600
(703) 221-4466
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003313
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008939152
—
VA
Enumeration date
11/10/2010
Last updated
11/10/2010
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