Individual
LAURA WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3930 WALNUT ST STE 250, FAIRFAX, VA 22030-4750
(703) 782-3710
Mailing address
11089 SAFFOLD WAY, RESTON, VA 20190-3815
(919) 410-0412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012276
VA
Other
Enumeration date
09/29/2021
Last updated
10/25/2023
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