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General NPI Number Information
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NPI Number | 1750581955
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Entity Type | Organization
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Legal Business Name | MINDWELL PSYCHOLOGY
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 14110 ROBERT PARIS CT
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City | CHANTILLY
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State | VA
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Zip | 20151-4205
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Country | US
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Telephone | 703-378-7998
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Fax | 703-378-6109
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Provider Business Mailing Address
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Address Line | 14110 ROBERT PARIS CT
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City | CHANTILLY
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State | VA
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Zip | 20151-4205
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Country | US
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Telephone | 703-378-7998
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Fax | 703-378-6109
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Authorized Official
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Title or Position | CO-OWNER, PRESIDENT
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Name | DR. RACHNA VARIA
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Credential | PHD
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Telephone | 703-378-7998
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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 | 0810002834
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License Number State | VA
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