Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0904008867 | VA |
NPI | 1003207127 |
---|---|
Provider Name | Brittany Lutz Estep |
First Address | Vienna, VA 22180-4641 |
Second Address | Vienna, VA 22180-4641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2015 |
Last Update Date | 13/03/2017 |