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General NPI Number Information
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NPI Number | 1285776641
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Entity Type | Organization
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Legal Business Name | CHERYL A. COLECCHI, PH.D., P.C.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 205 S WHITING ST SUITE 603
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7100
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Country | US
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Telephone | 703-751-0255
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Fax | 703-751-4943
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Provider Business Mailing Address
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Address Line | 205 S WHITING ST SUITE 603
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7100
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Country | US
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Telephone | 703-751-0255
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Fax | 703-751-4943
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHERYLY A. COLECCHI
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Credential | PH.D.
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Telephone | 703-751-0255
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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 | 0810001981
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License Number State | VA
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