Individual
STACEY DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 CENTREVILLE RD STE 400, MANASSAS, VA 20110-8411
(571) 377-6300
Mailing address
8700 CENTREVILLE RD STE 400, MANASSAS, VA 20110-8411
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-0607054
VA
Other
Enumeration date
08/06/2020
Last updated
12/01/2020
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