Organization
OLD TOWN PROFESSIONAL PSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNDAR COOK PSY.D (PSYCHOLOGIST)
(540) 931-5238
Entity
Organization
Contact information
Practice address
411 1/2 N WASHINGTON ST, ALEXANDRIA, VA 22314-2311
(571) 327-0194
Mailing address
411 1/2 N WASHINGTON ST, ALEXANDRIA, VA 22314-2311
(540) 931-5238
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
Other
Enumeration date
05/05/2020
Last updated
05/13/2020
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