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Organization

FAMILYFIRST PSYCHOLOGICAL SERVICES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KELLY THEIS PH.D. (PRESIDENT)
(703) 938-9090
Entity
Organization

Contact information

Practice address
115 PARK ST SE, SUITE 207, VIENNA, VA 22180-4653
(703) 938-9090
(703) 938-9091
Mailing address
115 PARK ST SE, SUITE 207, VIENNA, VA 22180-4653
(703) 938-9090
(703) 938-9091

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810003318
VA

Other

Enumeration date
09/08/2010
Last updated
09/08/2010
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