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General NPI Number Information
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NPI Number | 1104255686
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Entity Type | Individual
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Provider Name | MARIA THESTRUP PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 1010 WISCONSIN AVE NW SUITE 505
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City | WASHINGTON
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State | DC
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Zip | 20007-3603
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Country | US
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Telephone | 703-798-2838
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Fax |
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Provider Business Mailing Address
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Address Line | 43 U ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-1010
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Country | US
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Telephone | 703-798-2838
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1000865
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License Number State | DC
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