Individual
DR. KYLE STANDIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
360 MAPLE AVE W STE F, VIENNA, VA 22180-5614
(703) 938-0058
Mailing address
360 MAPLE AVE W STE F, VIENNA, VA 22180-5614
(703) 935-0058
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810006379
VA
Other
Enumeration date
06/06/2016
Last updated
07/20/2020
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