Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | PRC35 | DC |
Y | 225C00000X | Rehabilitation Counselor | 0715005211 | VA |
NPI | 1205952371 |
---|---|
Provider Name | Dr. Victor Alberto Wenger |
First Address | Fairfax, VA 22032-3828 |
Second Address | Fairfax, VA 22032-3828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 16/11/2008 |