Provider Demographics
NPI:1568948677
Name:MURILLO, AJA MIYUKI (LCSW)
Entity Type:Individual
Prefix:
First Name:AJA
Middle Name:MIYUKI
Last Name:MURILLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35174 DENISE WAY
Mailing Address - Street 2:
Mailing Address - City:ROUND HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20141-2289
Mailing Address - Country:US
Mailing Address - Phone:253-222-1011
Mailing Address - Fax:
Practice Address - Street 1:201 LIBERTY ST SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2721
Practice Address - Country:US
Practice Address - Phone:571-442-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker