Individual
JASON NORTHRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
8928 FALLING CREEK CT, ANNANDALE, VA 22003-4108
(585) 414-4836
Mailing address
8928 FALLING CREEK CT, ANNANDALE, VA 22003-4108
(585) 414-4836
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810008024
VA
Other
Enumeration date
05/04/2021
Last updated
11/06/2024
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