Healthcare Provider Details

I. General information

NPI: 1871247056
Provider Name (Legal Business Name): ARIANNA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 GREENSBORO DR STE 550
MC LEAN VA
22102-5146
US

IV. Provider business mailing address

12806 BRIERY RIVER TER
HERNDON VA
20170-2862
US

V. Phone/Fax

Practice location:
  • Phone: 240-444-0554
  • Fax:
Mailing address:
  • Phone: 240-444-0554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number0810007308
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: