Organization
SUSAN COOK MAYTORENA, PH.D., PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN COOK MAYTORENA PH.D. (OWNER)
(703) 519-6770
Entity
Organization
Contact information
Practice address
629 S WASHINGTON ST, ALEXANDRIA, VA 22314-4109
(703) 519-6770
(703) 229-0801
Mailing address
629 S WASHINGTON ST, ALEXANDRIA, VA 22314-4109
(703) 519-6770
(703) 229-0801
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000296
VA
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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