Healthcare Provider Details

I. General information

NPI: 1851723100
Provider Name (Legal Business Name): CHRISTINA MELUZIO PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 ASHTON AVE 200
MANASSAS VA
20109-5698
US

IV. Provider business mailing address

8140 ASHTON AVE 200
MANASSAS VA
20109-5698
US

V. Phone/Fax

Practice location:
  • Phone: 703-330-9933
  • Fax: 703-368-8454
Mailing address:
  • Phone: 703-330-9933
  • Fax: 703-368-8454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004830
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: