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General NPI Number Information
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NPI Number | 1801387311
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Entity Type | Individual
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Provider Name | LAILA SALEM FARMAND PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 2200 WILSON BLVD STE 412
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City | ARLINGTON
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State | VA
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Zip | 22201-3324
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Country | US
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Telephone | 571-328-7408
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Fax | 844-249-5577
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Provider Business Mailing Address
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Address Line | 2442 S WALTER REED DR UNIT A
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City | ARLINGTON
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State | VA
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Zip | 22206-4090
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Country | US
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Telephone | 703-629-3870
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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 | PY9475
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License Number State | FL
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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 | 0810005857
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License Number State | VA
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