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General NPI Number Information
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NPI Number | 1073318556
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Entity Type | Individual
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Provider Name | DR. JAYOTI SOOR
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 21351 GENTRY DR STE 200
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City | STERLING
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State | VA
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Zip | 20166-8512
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Country | US
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Telephone | 703-493-0891
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Fax | 703-552-1948
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Provider Business Mailing Address
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Address Line | 210 E FAIRFAX ST APT 507
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City | FALLS CHURCH
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State | VA
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Zip | 22046-2909
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Country | US
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Telephone | 703-419-0311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0805002634
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License Number State | VA
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