| Doctor Name: | MRS. LETICIA SALO ISIDRO-CLANCY |
| NPI Number: | 1043353576 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC-MFT, LADC |
| License Number: | 37PC00078400 |
| Business Practice Address: | 9300 Dewitt Loop, River Pavilion 2nd Floor R2.301 Fort Belvoir Community Hospital Fort Belvoir, VA - 22060 |
| Business Phone Number: | 5712311292 |
| Business Fax Number: | 5712311283 |
| Mailing Address: | 8906 Bluffwood Ln, FORT WASHINGTON |
| State: | MD |
| Postal Code: | 207446764 |
| Phone Number: | 5712311292 |
| Fax Number: | 5712313224 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 06/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 37PC00078400 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |