Doctor Name: | ROGER DREW |
NPI Number: | 1053478974 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, MFT |
License Number: | 2251 |
Business Practice Address: | 107 E Holly Ave Suite 13 Sterling, VA - 201645405 |
Business Phone Number: | 7034445833 |
Business Fax Number: | |
Mailing Address: | 19859 Memory Ln, POTOMAC FALLS |
State: | VA |
Postal Code: | 201652501 |
Phone Number: | 7038500709 |
Fax Number: | |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2251 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |