Individual
ETHAN SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
6400 SEVEN CORNERS PL, SUITE R, FALLS CHURCH, VA 22044-2009
(703) 819-6177
Mailing address
6400 SEVEN CORNERS PL, SUITE R, FALLS CHURCH, VA 22044-2009
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004627
VA
Other
Enumeration date
08/27/2012
Last updated
10/17/2016
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