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General NPI Number Information
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NPI Number | 1922126838
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Entity Type | Organization
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Legal Business Name | KEY ASSESSMENTS AND SOLUTIONS
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 7404 GALLERHER RD
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City | GAINESVILLE
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State | VA
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Zip | 20155-1602
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Country | US
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Telephone | 703-898-2287
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Fax | 703-991-0884
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Provider Business Mailing Address
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Address Line | PO BOX 121
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City | GAINESVILLE
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State | VA
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Zip | 20156-0121
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Country | US
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Telephone | 703-898-2287
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Fax | 703-991-0884
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. AMY MUNTZ FISCH
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Credential | PH.D.
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Telephone | 703-898-2287
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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 | 0810000368
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License Number State | VA
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