Individual
DR. NICHOLAS JD TISCIONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
209 ELDEN ST, #305, HERNDON, VA 20170-4852
(703) 471-4540
Mailing address
209 ELDEN ST, #305, HERNDON, VA 20170-4852
(703) 471-4540
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
81000143
VA
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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