Individual
DR. MARTINA PAVLICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
11130 FAIRFAX BLVD STE 305, FAIRFAX, VA 22030-5035
(703) 691-1326
Mailing address
205 YOAKUM PKWY UNIT 1802, ALEXANDRIA, VA 22304-3852
(202) 744-4065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004418
VA
Other
Enumeration date
06/03/2011
Last updated
06/03/2011
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