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1114699048
MICHAEL ALLISON RIDGE
FAIRFAX, VA
NPI
1114699048
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904009175)
Enumeration Date
2021-09-29
Last Update Date
2021-09-29
Business Address
MICHAEL ALLISON RIDGE LCSW
10615 JUDICIAL DR STE 301
FAIRFAX, VA 22030-7501
Phone number: 703-667-0752
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Mailing Address
MICHAEL ALLISON RIDGE LCSW
502 W BROAD ST APT 317
FALLS CHURCH, VA 22046-3244
Phone number: 703-966-9658
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