Healthcare Provider Details

I. General information

NPI: 1891201745
Provider Name (Legal Business Name): HANNAH TINDALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8115 GATEHOUSE RD
FALLS CHURCH VA
22042-1203
US

IV. Provider business mailing address

8115 GATEHOUSE RD
FALLS CHURCH VA
22042-1203
US

V. Phone/Fax

Practice location:
  • Phone: 864-710-2046
  • Fax:
Mailing address:
  • Phone: 864-710-2046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPPS-0609165
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: