DEITRA LATRICE FANT

ALEXANDRIA, VA
NPI1699131896
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: MD  LC10267)
Additional Taxonomies101YM0800X Counselor, Mental Health
101YM0800X Counselor, Mental Health
(Licence: MD  LC10267)
101YP2500X Counselor, Professional
(Licence: LA  08861)
101YP2500X Counselor, Professional
(Licence: VA  0701009874)
101YP2500X Counselor, Professional
(Licence: DC  PRC15297)
171M00000X Case Manager/Care Coordinator
172V00000X Community Health Worker
251S00000X Community/Behavioral Health
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
261QM0850X Clinic/Center, Adult Mental Health
261QM0855X Clinic/Center, Adolescent and Children Mental Health
Enumeration Date2016-01-05
Last Update Date2025-01-24
Business Address
Mrs. DEITRA LATRICE FANT MA,NCC,LCPC,LPC
118 N SAINT ASAPH ST STE G
ALEXANDRIA, VA 22314-3110
Phone number: 703-857-5354
Mailing Address
Mrs. DEITRA LATRICE FANT MA,NCC,LCPC,LPC
137 NATIONAL PLZ STE 300
OXON HILL, MD 20745-1153
Phone number: 703-857-5354