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Individual

COURTNEY THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
530 HUNTMAR PARK DR, SUITE A, HERNDON, VA 20170-5100
(925) 325-3701
Mailing address
1788 WAINWRIGHT DR, RESTON, VA 20190-3442
(925) 325-3701

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003763
VA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY19714
CA

Other

Enumeration date
10/18/2005
Last updated
03/19/2014
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