Individual
DR. JONATHAN DERIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4320 PRINCE WILLIAM PKWY STE 109, WOODBRIDGE, VA 22192-8100
(703) 957-7300
Mailing address
4320 PRINCE WILLIAM PKWY STE 109, WOODBRIDGE, VA 22192-8100
(703) 957-7300
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
0810005434
VA
103TF0200X
Forensic Psychologist
0810005434
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/02/2014
Last updated
03/17/2018
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