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General NPI Number Information
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NPI Number | 1548204316
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Entity Type | Individual
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Provider Name | GLORIA KAY VANDERHORST PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 7910 WOODMONT AVE SUITE 1101
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City | BETHESDA
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State | MD
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Zip | 20814-3002
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Country | US
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Telephone | 301-578-8760
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Fax |
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Provider Business Mailing Address
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Address Line | 3117 WINNETT RD
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City | CHEVY CHASE
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State | MD
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Zip | 20815-3265
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Country | US
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Telephone | 301-578-8760
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0980
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License Number State | MD
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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 | PSY1000365
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License Number State | DC
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