Individual
DR. JOHN JOSEPH GUALTIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
1515 CHAIN BRIDGE RD, SUITE G14, MCLEAN, VA 22101-4451
(703) 790-8111
Mailing address
1515 CHAIN BRIDGE RD, SUITE G14, MCLEAN, VA 22101
(703) 790-8111
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001429
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090799
ANTHEM
VA
01
—
22656
ALLIANCE PPO
VA
01
—
A839 0001
CAREFIRST BCBS
VA
Enumeration date
02/15/2007
Last updated
07/08/2007
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