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For all new clients, please complete all forms and the intake form that applies to you and bring all completed forms to your first session
Informed Consent
Client Registration
Release of Information
HIPPA Authorization
Adolescent Intake Form
Adult Intake Form
Dr. Patricia A. Profit
Licensed Professional Counselor
License Number: VA 0701011227
NPI: 1952828675; Tax ID: 82-2542280
4213 Dale Blvd Woodbridge, VA 22193
703-730
-1393
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