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General NPI Number Information
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NPI Number | 1184746208
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Entity Type | Individual
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Provider Name | PATRICK JOSEPH MAHONEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1634 I ST NW SUITE 700
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City | WASHINGTON
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State | DC
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Zip | 20006-4003
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Country | US
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Telephone | 202-639-4960
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Fax | 703-243-4366
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Provider Business Mailing Address
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Address Line | 894 N KENSINGTON ST
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City | ARLINGTON
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State | VA
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Zip | 22205-1328
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Country | US
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Telephone | 703-243-4366
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Fax | 703-243-4366
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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 | PSY1488
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License Number State | DC
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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 | 0810003140
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License Number State | VA
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