Healthcare Provider Details

I. General information

NPI: 1497708424
Provider Name (Legal Business Name): KRISTIN OSCAR ZAUEL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 FAIRFAX DR STE 205
ARLINGTON VA
22203-1622
US

IV. Provider business mailing address

7504 S VALLEY DR
FAIRFAX STATION VA
22039-2963
US

V. Phone/Fax

Practice location:
  • Phone: 571-328-7408
  • Fax:
Mailing address:
  • Phone: 703-440-5739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1001055
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004657
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: