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General NPI Number Information
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NPI Number | 1972970317
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Entity Type | Individual
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Provider Name | ALICE THOMAS PH.D
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Gender | Female
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 6516 RIVER TWEED LN
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City | ALEXANDRIA
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State | VA
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Zip | 22312-3138
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Country | US
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Telephone | 202-621-1854
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 PENNSYLVANIA AVE NW STE 400
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City | WASHINGTON
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State | DC
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Zip | 20004-1017
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Country | US
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Telephone | 703-621-1854
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Fax | 202-315-3404
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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 | PSY1000021
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License Number State | DC
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