| Mindful Legacy Llc | |
|
4229 Jefferson Oaks Cir Apt B Fairfax VA 22033-4071 | |
| (703) 718-6413 | |
| Not Available |
| Full Name | Mindful Legacy Llc |
|---|---|
| Speciality | Counselor |
| Location | 4229 Jefferson Oaks Cir Apt B, Fairfax, Virginia |
| Authorized Official Name and Position | Shekila S Melchior (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 3363019765 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Legacy Llc 12587 Fair Lakes Cir # 406 Fairfax VA 22033-3822 Ph: (336) 301-9765 | Mindful Legacy Llc 4229 Jefferson Oaks Cir Apt B Fairfax VA 22033-4071 Ph: (703) 718-6413 |
| NPI Number | 1013606326 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 12/11/2023 |
| Certification Date | 12/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013606326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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