Fountain of Life LLC
Fountain of Life LLC provides Clinical Psychologist services in Falls Church, Virginia. Licensed in Virginia. Registered with an NPI since 2017.
- Licensed in
- VA
- In the registry since
- 2017
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
450 W Broad St Ste 211Falls Church, VA 22046-3318
Phone: (571) 277-4919
Fax: (703) 241-1122
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Psychologist (primary) | Taxonomy 103TC0700X · Licence 0810002980 (VA) |
|---|
Record details
| NPI number | 1396286019 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Lisa Klewicki — Clinical Psychologist · (571) 277-4919 |
| NPI enumerated | March 14, 2017 |
| Last updated in NPPES | March 14, 2017 |
| Mailing address | 450 W Broad St Ste 211, Falls Church, VA 22046-3318 |
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