Individual
LAURENTIA MEADE RUBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
10195 MAIN ST, SUITE N, FAIRFAX, VA 22031-3415
(703) 591-9600
Mailing address
10195 MAIN ST, SUITE N, FAIRFAX, VA 22031-3415
(703) 591-9600
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003761
VA
103TC0700X
Clinical Psychologist
PSY1000407
DC
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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