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General NPI Number Information
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NPI Number | 1841420759
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Entity Type | Organization
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Legal Business Name | J.LAWRENCE JAMIESON,PH.D.,P.C.
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 3923 OLD LEE HWY STE 63D
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City | FAIRFAX
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State | VA
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Zip | 22030-2428
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Country | US
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Telephone | 703-691-2408
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Fax | 703-691-2103
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Provider Business Mailing Address
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Address Line | 3923 OLD LEE HWY STE 63D
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City | FAIRFAX
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State | VA
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Zip | 22030-2428
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Country | US
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Telephone | 703-691-2408
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Fax | 703-691-2103
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. J. LAWRENCE JAMIESON
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Credential | PH.D.
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Telephone | 703-691-2408
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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 | 0810002322
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License Number State | VA
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