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NPI Code Detail

MEDICARE: NICOLE O'BRIEN

MEDICARE: NICOLE O'BRIEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool PsychologistVA

General Provider Information

NPI Number : 1013871896
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE O'BRIEN
Provider Business Mailing Address
First Line : 1340 BRADDOCK PL
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-1693
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1340 BRADDOCK PL
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-1693
Country : US
Telephone Number : 703-619-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ NICOLE O'BRIEN ” Practice Location

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