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Individual

DR. KATHLEEN ANN CHRISTIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
11250 ROGER BACON DR STE 5, RESTON, VA 20190-5202
(571) 299-8616
Mailing address
12150 PURPLE SAGE CT, RESTON, VA 20194-5621
(571) 299-8616

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810005019
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08110005019
LICENSED CLINICAL PSYCHOLOGIST
VA
Enumeration date
08/15/2017
Last updated
08/15/2017
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