Individual
ELIZABETH NICOLE WIEDERHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6400 GROVEDALE DR STE 200, ALEXANDRIA, VA 22310-2504
(571) 356-8360
Mailing address
6400 GROVEDALE DR STE 200, ALEXANDRIA, VA 22310-2504
(571) 356-8360
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701013940
VA
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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