Healthcare Provider Details

I. General information

NPI: 1881354447
Provider Name (Legal Business Name): RACHAEL PAWLOWICZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8221 WILLOW OAKS CORPORATE DR STE 4-430
FAIRFAX VA
22031-4512
US

IV. Provider business mailing address

618 T ST NW APT 608
WASHINGTON DC
20001-5745
US

V. Phone/Fax

Practice location:
  • Phone: 703-289-7560
  • Fax: 703-289-4612
Mailing address:
  • Phone: 630-310-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810007668
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: