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HEALING TREE CLINIC, LLC

Counseling >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1316538242

Organizational Registrant:
Organization Name:  HEALING TREE CLINIC, LLC
Organization is not Subpart
Authorized Official:  LINA  LIW  DIRECTOR  765--41-80080

Location and contact information for practice:
11402 ARISTOTLE DR APT 2313  FAIRFAX, VA 22030-7519 US
Tel: 765-418-0080  Fax: --

Contact information for business:
11402 ARISTOTLE DR APT 2313  FAIRFAX, VA 22030-7519 US
Tel: 765-418-0080  Fax: --

Registration Information:
NPI: 1316538242
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TC1900XBehavioral Health & Social Service Providers
Psychologist
Counseling

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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