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Contact Information

JENNIFER L SHORE, PSY.D.
3554 CHAIN BRIDGE ROAD
SUITE 200
FAIRFAX, VA22030
 Phone: 703-896-7628
 Fax: 703-890-2359
 Website: http://www.fairfaxpsych.com
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JENNIFER L SHORE · (Female)

NPI Number 1417225863
Status Active
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 12/13/2011
Last updated 12/15/2016 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 0810004513
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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