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NURTURE CHILD AND FAMILY, PLLC

Clinical Child & Adolescent >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1639530629

Organizational Registrant:
Organization Name:  NURTURE CHILD AND FAMILY, PLLC
Organization is not Subpart
Authorized Official:  MARK STEVEN GARDNER  MEMBER  703--34-15995

Location and contact information for practice:
1319 VINCENT PL  MC LEAN, VA 22101-3615 US
Tel: 703-341-5995  Fax: 703-341-5995

Contact information for business:
1319 VINCENT PL  MC LEAN, VA 22101-3615 US
Tel: 703-341-5995  Fax: 703-341-5995

Registration Information:
NPI: 1639530629
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TC2200XBehavioral Health & Social Service Providers
Psychologist
Clinical Child & Adolescent
VA080003355
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
VA904005796

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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