Organization
J.LAWRENCE JAMIESON,PH.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. LAWRENCE JAMIESON PH.D. (PRESIDENT)
(703) 691-2408
Entity
Organization
Contact information
Practice address
3923 OLD LEE HWY STE 63D, FAIRFAX, VA 22030-2428
(703) 691-2408
(703) 691-2103
Mailing address
3923 OLD LEE HWY STE 63D, FAIRFAX, VA 22030-2428
(703) 691-2408
(703) 691-2103
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002322
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069293
ANTHEM,BCBS OF VIRGINIA
VA
01
—
659354
MEDICARE
VA
01
—
R39600
VALUE OPTIONS
VA
Enumeration date
07/27/2009
Last updated
07/27/2009
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