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Contact Information

360 PYSCHOLOGICAL SERVICES
1133 HEATHERSTONE DR STE 102
FREDERICKSBURG, VA22407-4828
 Phone: 540-702-8573
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for 360 PYSCHOLOGICAL SERVICES · (Female)

NPI Number 1790802478
Status Active
Credentials
Entity Individual
Enumeration date 03/26/2007
Last updated 11/29/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 0810002447
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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