Individual
JASON MATHISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D, NCSP, ABSNP
Contact information
Practice address
407 MOUNT VERNON AVE, ALEXANDRIA, VA 22301-2233
(703) 967-0631
Mailing address
7283 SWAN POINT WAY, COLUMBIA, MD 21045-5059
(703) 967-0631
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0803000222
VA
Other
Enumeration date
04/14/2009
Last updated
04/18/2013
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