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General NPI Number Information
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NPI Number | 1760598312
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Entity Type | Individual
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Provider Name | JILL PARKS WEBER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 7927 JONES BRANCH DR SUITE: 6125
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City | MC LEAN
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State | VA
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Zip | 22102-3322
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Country | US
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Telephone | 703-541-1277
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Fax | 703-992-0993
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Provider Business Mailing Address
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Address Line | 7927 JONES BRANCH DR SUITE: 6125
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City | MC LEAN
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State | VA
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Zip | 22102-3322
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Country | US
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Telephone | 703-541-1277
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Fax | 703-992-0993
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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 | 0810003470
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License Number State | VA
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