Healthcare Provider Details

I. General information

NPI: 1063565430
Provider Name (Legal Business Name): BRIAN CHANDLER HAND PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12866 HARBOR DR
WOODBRIDGE VA
22192-2921
US

IV. Provider business mailing address

12866 HARBOR DR
WOODBRIDGE VA
22192-2921
US

V. Phone/Fax

Practice location:
  • Phone: 703-497-0282
  • Fax: 703-490-4906
Mailing address:
  • Phone: 703-497-0282
  • Fax: 703-490-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810001760
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: