Individual
DR. MICHAEL MAGENHEIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4430 13TH PL NE, WASHINGTON, DC 20017-2729
(516) 857-1654
Mailing address
4430 13TH PL NE, WASHINGTON, DC 20017-2729
(516) 857-1654
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810005605
PROFESSIONAL LICENSE NUMBER
VA
Enumeration date
08/02/2020
Last updated
08/02/2020
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