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1215098116
JAIME JESUS HENAO
ALEXANDRIA, VA
NPI
1215098116
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: VA 0710101709)
Enumeration Date
2006-12-13
Last Update Date
2007-07-08
Business Address
JAIME JESUS HENAO CSAC
720 N SAINT ASAPH ST
ALEXANDRIA, VA 22314-1912
Phone number: 703-838-4455
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Mailing Address
JAIME JESUS HENAO CSAC
5940 COVE LANDING RD
BURKE, VA 22015-4790
Phone number: 703-250-8766
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