Individual
KEITH D RENSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10340 DEMOCRACY LN, STE 202, FAIRFAX, VA 22030-2518
(703) 993-5128
(703) 993-1359
Mailing address
4400 UNIVERSITY DR, MSN3F5 DEPARTMENT OF PSYCHOLOGY, FAIRFAX, VA 22030-4444
(703) 993-5128
(703) 993-1359
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004355
VA
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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