Provider Demographics
NPI:1144950544
Name:GIRAUD, ALICE BELEN
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:BELEN
Last Name:GIRAUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 GREEN ASH LOOP APT 201
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4155
Mailing Address - Country:US
Mailing Address - Phone:214-354-2645
Mailing Address - Fax:
Practice Address - Street 1:8140 ASHTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5701
Practice Address - Country:US
Practice Address - Phone:214-354-2645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health