person
Mylisa L Ickes, LPC
Professional Counselor in Manassas, Virginia
NPI 1861995060

Mylisa L Ickes is a Professional Counselor based in Gainesville, VA and is specialized in Professional. Mylisa L Ickes practices in Manassas, VA and has the professional credentials of LPC. The NPI Number for Mylisa L Ickes is 1861995060 and holds a License No. 0701007547 (Virginia).

The current practice location address for Mylisa L Ickes is 7982 Donegan Drive, Manassas, VA and can be reached out via phone at 571-248-2358.

Location: 7982 Donegan Drive, Manassas, VA, 20155-3414
person
Provider Profile Details
NPI Number
1861995060
Provider Name
Mylisa L Ickes
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
7982 Donegan Drive, Manassas, VA, 20155-3414
Phone Number
571-248-2358
Fax Number
Provider Enumeration Date
03/14/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7982 Donegan Drive
City
State
Zip
20109
Phone Number
571-248-2358
Fax Number
person
Provider Business Mailing Address Details
Address
7982 Donegan Drive
City
State
Zip
20109
Phone Number
571-248-2358
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
0701007547 (Virginia)
Definition
Definition to come...
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