Healthcare Provider Details

I. General information

NPI: 1922472943
Provider Name (Legal Business Name): KATHERINE SNABLY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE ROBINSON

II. Dates (important events)

Enumeration Date: 11/16/2015
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 PRINCE WILLIAM PKWY SUITE 109
WOODBRIDGE VA
22192-8100
US

IV. Provider business mailing address

4320 PRINCE WILLIAM PKWY SUITE 109
WOODBRIDGE VA
22192-8100
US

V. Phone/Fax

Practice location:
  • Phone: 703-969-3275
  • Fax:
Mailing address:
  • Phone: 703-969-3275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004952
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: