Healthcare Provider Details

I. General information

NPI: 1821215609
Provider Name (Legal Business Name): SARAH ALICE HOVER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 MAPLE AVE W SUITE 303
VIENNA VA
22180-5620
US

IV. Provider business mailing address

380 MAPLE AVE W SUITE 303
VIENNA VA
22180-5620
US

V. Phone/Fax

Practice location:
  • Phone: 703-938-5234
  • Fax: 703-938-2949
Mailing address:
  • Phone: 703-938-5234
  • Fax: 703-938-2949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number0810002719
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: