Doctor Name: | JESSICA MACNAIR |
NPI Number: | 1003169681 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 0701004421 |
Business Practice Address: | 2762 Marshall St Falls Church, VA - 220422003 |
Business Phone Number: | 5713350423 |
Business Fax Number: | |
Mailing Address: | 2762 Marshall St, FALLS CHURCH |
State: | VA |
Postal Code: | 220422003 |
Phone Number: | 5713350423 |
Fax Number: | |
NPI Enumeration Date: | 10/19/2012 |
NPI Last Update Date: | 10/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0701004421 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |