Organization
NOVA TERRA THERAPY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BROKAMP LPC (FOUNDER)
(703) 868-8609
Entity
Organization
Contact information
Practice address
5213A LYNGATE CT, BURKE, VA 22015-1698
(703) 868-8609
Mailing address
7807 S VALLEY DR, FAIRFAX STATION, VA 22039-2971
(703) 868-8609
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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