Individual
MADALYN HUMPHREYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CSOTP, LPC
Contact information
Practice address
10623 JONES ST STE 301A, FAIRFAX, VA 22030-7512
(703) 267-5703
Mailing address
4800 28TH ST S APT H, ARLINGTON, VA 22206-1300
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010088
VA
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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