| Doctor Name: | MRS. THERESA M. SHALTANIS |
| NPI Number: | 1023170180 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., LPC, LMFT |
| License Number: | 0701002445 |
| Business Practice Address: | 10372b Democracy Ln Fairfax, VA - 22030 |
| Business Phone Number: | 7035912551 |
| Business Fax Number: | |
| Mailing Address: | 10372-b Democracy Ln, FAIRFAX |
| State: | VA |
| Postal Code: | 22030 |
| Phone Number: | 7032899728 |
| Fax Number: | |
| NPI Enumeration Date: | 12/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701002445 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |