| Doctor Name: | MRS. PATRICIA SUSAN SMALL |
| NPI Number: | 1013139724 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | 0701003825 |
| Business Practice Address: | 11250 Roger Bacon Dr Suite 6 Reston, VA - 201905219 |
| Business Phone Number: | 7034039773 |
| Business Fax Number: | |
| Mailing Address: | 11250 Roger Bacon Dr, Suite 6 RESTON |
| State: | VA |
| Postal Code: | 201905219 |
| Phone Number: | 7034039773 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 11/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701003825 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |