Provider Information for 1013906478
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COURTNEY THOMAS Psy.D.
Sex: Female
NPI: 1013906478
Last Updated: 2014-03-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1013906478 | ||||||||||||
| Enumeration Date | 2005-10-18 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1788 WAINWRIGHT DR RESTON, VA 20190-3442 United States Phone: 925-325-3701 | Fax: | ||||||||||||
| Primary Practice Address | 530 HUNTMAR PARK DR SUITE A HERNDON, VA 20170-5100 United States Phone: 925-325-3701 | Fax: | ||||||||||||
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