Individual
DR. OLIVIA SOUTULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5980
Mailing address
2233 WISCONSIN AVE NW STE 317, WASHINGTON, DC 20007-4104
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY1001541
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY1001541
DC BOARD OF PSYCHOLOGY
DC
Enumeration date
10/10/2019
Last updated
10/10/2019
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