Individual
ELLEN SUSAN NASANOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
8618 WESTWOOD CENTER DR, 340, VIENNA, VA 22182-2222
(202) 531-2126
Mailing address
1390 CHAIN BRIDGE RD, #207, MC LEAN, VA 22101-3904
(202) 531-2126
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004071
VA
103TC0700X
Clinical Psychologist
PSY523
CA
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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