Organization
EVIDENCE BASED TREATMENT COLLABORATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOANNA MARINO PHD (CEO)
(571) 477-1611
Entity
Organization
Contact information
Practice address
4000 LEGATO RD FL 11, FAIRFAX, VA 22033-2892
(571) 206-1747
Mailing address
4000 LEGATO RD FL 11, FAIRFAX, VA 22033-2892
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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