Individual
JEANINE RUTH CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1487 CHAIN BRIDGE RD, SUITE 202, MC LEAN, VA 22101-5723
(703) 919-0917
(703) 536-4693
Mailing address
1487 CHAIN BRIDGE RD, SUITE 202, MC LEAN, VA 22101-5723
(703) 919-0917
(703) 536-4693
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2073
VA
Other
Enumeration date
08/07/2007
Last updated
09/11/2012
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