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General NPI Number Information
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NPI Number | 1407767551
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Entity Type | Individual
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Provider Name | MEGHAN MADDOCK PHD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 7051 HEATHCOTE VILLAGE WAY STE 265
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City | GAINESVILLE
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State | VA
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Zip | 20155-3267
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Country | US
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Telephone | 703-754-0636
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Fax |
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Provider Business Mailing Address
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Address Line | 7389 CROWN LN
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City | WARRENTON
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State | VA
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Zip | 20187-9046
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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 | 12987150-2501
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810009373
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License Number State | VA
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