Doctor Name: | GRETTA HERBERT |
NPI Number: | 1780078030 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OFFICE ADMINISTRATOR |
License Number: | 541148368 |
Business Practice Address: | 3620 Joseph Siewick Dr Suite 307 Fairfax, VA - 220331756 |
Business Phone Number: | 7032811023 |
Business Fax Number: | 7036202331 |
Mailing Address: | 3620 Joseph Siewick Dr, Suite 307 FAIRFAX |
State: | VA |
Postal Code: | 220331756 |
Phone Number: | 7032811023 |
Fax Number: | 7036202331 |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 541148368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |