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General NPI Number Information
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NPI Number | 1114017399
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Entity Type | Individual
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Provider Name | EDWARD DAVID FARBER PHD
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 TOWN CENTER DR #411
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City | RESTON
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State | VA
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Zip | 20190
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Country | US
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Telephone | 703-437-3236
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Fax | 703-435-7422
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Provider Business Mailing Address
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Address Line | 1800 TOWN CENTER DRIVE SUITE 411
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City | RESTON
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State | VA
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Zip | 20190
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Country | US
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Telephone | 703-437-3236
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Fax | 703-435-7422
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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 | 0810001291
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 01681
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License Number State | MD
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