Individual
MS. DIANE LOUISE WOOLHEATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6525 MONTROSE ST, ALEXANDRIA, VA 22312-2245
(703) 658-5900
Mailing address
8270 WILLOW OAKS CORPORATE DR FL 3, FAIRFAX, VA 22031-4511
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000678
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0813000678
DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
04/30/2018
Last updated
04/30/2018
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