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General NPI Number Information
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NPI Number | 1912455056
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Entity Type | Individual
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Provider Name | MARY KATHLEEN HIGGINS NEYLAND PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 6026 MADISON OVERLOOK CT
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3651
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Country | US
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Telephone | 703-457-6545
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Fax | 877-706-1876
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Provider Business Mailing Address
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Address Line | 6026 MADISON OVERLOOK CT
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3651
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Country | US
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Telephone | 703-457-6545
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Fax | 877-706-1876
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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 | 0810005795
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License Number State | VA
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