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1215360532
PHYLLIS M FORTUNATO MARTIN
FAIRFAX, VA
NPI
1215360532
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: VA 0701003077)
Enumeration Date
2013-08-11
Last Update Date
2013-08-11
Business Address
-- PHYLLIS M FORTUNATO MARTIN LPC
10400 EATON PL SUITE 110
FAIRFAX, VA 22030-2208
Phone number: 703-509-7412
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Mailing Address
-- PHYLLIS M FORTUNATO MARTIN LPC
10400 EATON PL SUITE 110
FAIRFAX, VA 22030-2208
Phone number: 703-509-7412
Copy
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