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General NPI Number Information
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NPI Number | 1255674206
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 09/06/2013
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Provider Practice Location Address
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Address Line | 3331 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4597
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Country | US
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Telephone | 703-828-7115
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Fax |
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Provider Business Mailing Address
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Address Line | 3331 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4597
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | DR. TASHNA MARIE FELIX
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Credential | PSY.D., CSOTP
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Telephone | 703-828-7115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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