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Derosa Wellness Innovation, Llc
Professional Counselor in Reston, Virginia
NPI 1124716519

Derosa Wellness Innovation, Llc is a Professional Counselor based in Reston, VA and is specialized in Professional. Derosa Wellness Innovation, Llc practices in Reston, VA. The NPI Number for Derosa Wellness Innovation, Llc is 1124716519 and holds a License No. (Virginia).

The current practice location address for Derosa Wellness Innovation, Llc is 11921 Freedom Dr Ste 550, Reston, VA and can be reached out via phone at 703-826-1353.

Location: 11921 Freedom Dr Ste 550, Reston, VA, 20190-5635
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1124716519
Provider Name
Derosa Wellness Innovation, Llc
Credential
Provider Entity Type
Organization
Address
11921 Freedom Dr Ste 550, Reston, VA, 20190-5635
Phone Number
703-826-1353
Fax Number
Provider Enumeration Date
04/25/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
11921 Freedom Dr Ste 550
City
Reston
State
Virginia
Zip
20190-5635
Phone Number
703-826-1353
Fax Number
person
Provider Business Mailing Address Details
Address
11921 Freedom Dr Ste 550
City
Reston
State
Virginia
Zip
20190-5635
Phone Number
703-826-1353
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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