Individual
MR. EDUARDO M AZCARATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6201 LEESBURG PIKE, FALLS CHURCH, VA 22044-2201
(703) 237-0725
Mailing address
6201 LEESBURG PIKE, FALLS CHURCH, VA 22044-2201
(703) 237-0725
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810000952
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12299964
CAQH
—
Enumeration date
09/10/2012
Last updated
09/10/2012
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