Healthcare Provider Details

I. General information

NPI: 1982922712
Provider Name (Legal Business Name): AMANDA L WARBEL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA L SABUCO

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8134 OLD KEENE MILL RD SUITE 101
SPRINGFIELD VA
22152-1800
US

IV. Provider business mailing address

8134 OLD KEENE MILL RD SUITE 101
SPRINGFIELD VA
22152-1800
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-8731
  • Fax:
Mailing address:
  • Phone: 703-569-8731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1000593
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: