Individual
JENNIFER ANN MOSSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
133 PARK ST NE, VIENNA, VA 22180-4602
(703) 281-2657
Mailing address
11534 HEARTHSTONE CT, RESTON, VA 20191-4415
(571) 243-8625
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004163
VA
Other
Enumeration date
10/29/2009
Last updated
10/29/2009
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