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Tisha Moon
Mental Health Counselor in Vienna, Virginia
NPI 1578137691

Tisha Moon is a Mental Health Counselor based in Reston, VA and is specialized in Mental Health. Tisha Moon practices in Vienna, VA. The NPI Number for Tisha Moon is 1578137691 and holds a License No. 0701010496 (Virginia).

The current practice location address for Tisha Moon is 114 Church St Nw Ste 205, Vienna, VA and can be reached out via phone at 540-999-8474.

Location: 114 Church St Nw Ste 205, Vienna, VA, 20191-4321
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578137691
Provider Name
Tisha Moon
Credential
Provider Entity Type
Individual
Gender
Female
Address
114 Church St Nw Ste 205, Vienna, VA, 20191-4321
Phone Number
540-999-8474
Fax Number
Provider Enumeration Date
05/13/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
114 Church St Nw Ste 205
City
Vienna
State
Virginia
Zip
22180-4507
Phone Number
540-999-8474
Fax Number
person
Provider Business Mailing Address Details
Address
114 Church St Nw Ste 205
City
Vienna
State
Virginia
Zip
22180-4507
Phone Number
540-999-8474
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
0701010496 (Virginia)
Definition
Definition to come...
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