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General NPI Number Information
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NPI Number | 1013337815
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Entity Type | Organization
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Legal Business Name | RISA E. SANDERS, PH.D., PLLC
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 1313 VINCENT PL
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City | MC LEAN
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State | VA
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Zip | 22101-3615
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Country | US
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Telephone | 703-919-1959
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 VINCENT PL
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City | MC LEAN
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State | VA
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Zip | 22101-3615
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Country | US
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Telephone | 703-919-1959
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/ OWNER
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Name | DR. RISA E SANDERS
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Credential | PH.D.
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Telephone | 703-919-1959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810002666
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License Number State | VA
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