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General NPI Number Information
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NPI Number | 1295444198
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Entity Type | Individual
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Provider Name | ALISHA NOEL STANLEY
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Gender | Female
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Dates
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Enumeration Date | 11/18/2022
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 9246 MOSBY ST UNIT A
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City | MANASSAS
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State | VA
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Zip | 20110-5038
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Country | US
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Telephone | 703-569-8731
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Fax |
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Provider Business Mailing Address
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Address Line | 12305 JARROW LN
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City | BRISTOW
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State | VA
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Zip | 20136-2061
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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 |
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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 | 0810007988
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License Number State | VA
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