Individual
DR. JESSICA LYNN CARDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-5698
(307) 763-2415
(703) 368-8454
Mailing address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-5698
(307) 763-2415
(703) 368-8454
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
471
WY
103TC0700X
Clinical Psychologist
Primary
0810004230
VA
Other
Enumeration date
11/24/2008
Last updated
03/29/2010
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