Individual
LAUREL WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4401 FAIRFAX DR STE 205, ARLINGTON, VA 22203-1622
(571) 328-7408
Mailing address
4401 FAIRFAX DR STE 205, ARLINGTON, VA 22203-1622
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
12/11/2020
Last updated
08/07/2023
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