Individual
DR. TERESA C SIMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11363 SUNSET HILLS RD, RESTON, VA 20190-5205
(703) 464-5445
Mailing address
11363 SUNSET HILLS RD, RESTON, VA 20190-5205
(703) 464-5445
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001453
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
284535
ANTHEM BCBS
VA
01
—
7070817
MAMSI
—
Enumeration date
09/20/2005
Last updated
10/29/2010
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