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General NPI Number Information
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NPI Number | 1831378694
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY ASSOCIATES OF NORTHERN VIRGINIA, LLC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 6723 WHITTIER AVE SUITE #206
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City | MC LEAN
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State | VA
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Zip | 22101-4522
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Country | US
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Telephone | 703-615-6186
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Fax | 703-356-9137
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Provider Business Mailing Address
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Address Line | 6723 WHITTIER AVE SUITE #206
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City | MC LEAN
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State | VA
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Zip | 22101-4522
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Country | US
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Telephone | 703-615-6186
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Fax | 703-356-9137
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MONA ABU-HAMDA
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Credential | PSY.D.
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Telephone | 703-615-6186
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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 | 0810003498
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License Number State | VA
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