Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0904008796 | VA |
NPI | 1003205584 |
---|---|
Provider Name | Christine M Marketti |
First Address | Arlington, VA 22204-5703 |
Second Address | Arlington, VA 22204-5717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2015 |
Last Update Date | 19/04/2018 |