Individual
DR. RICHARD ALAN GONTANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5691 COLUMBIA PIKE, SUITE 200, FALLS CHURCH, VA 22041
(703) 998-5606
(703) 998-5608
Mailing address
5691 COLUMBIA PIKE, SUITE 200, FALLS CHURCH, VA 22041
(703) 998-5606
(703) 998-5608
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003411
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185384
ANTHEM
—
01
—
28110017
CARE FIRST
—
Enumeration date
10/24/2006
Last updated
07/08/2007
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