Healthcare Provider Details

I. General information

NPI: 1437182656
Provider Name (Legal Business Name): MARY FRANCES PARTRIDGE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 01/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8519 TUTTLE RD BLDG B
SPRINGFIELD VA
22152-1508
US

IV. Provider business mailing address

8519 TUTTLE RD BLDG B
SPRINGFIELD VA
22152-1508
US

V. Phone/Fax

Practice location:
  • Phone: 703-644-9072
  • Fax: 703-644-9074
Mailing address:
  • Phone: 703-644-9072
  • Fax: 703-644-9074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810003727
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: