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1598873101
KELLY FACCIOLA
WOODBRIDGE, VA
NPI
1598873101
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: VA 0904005064)
Enumeration Date
2006-08-25
Last Update Date
2019-08-07
Business Address
KELLY FACCIOLA LCSW
12866 HARBOR DR
WOODBRIDGE, VA 22192-2921
Phone number: 703-494-4164
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Mailing Address
KELLY FACCIOLA LCSW
12866 HARBOR DR
WOODBRIDGE, VA 22192-2921
Phone number: 703-203-7535
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