| Doctor Name: | AVY STOCK |
| NPI Number: | 1003138744 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0810003939 |
| Business Practice Address: | 42009 Victory Ln Leesburg, VA - 201766269 |
| Business Phone Number: | 3307584515 |
| Business Fax Number: | 3307582862 |
| Mailing Address: | 42009 Victory Ln, LEESBURG |
| State: | VA |
| Postal Code: | 201766269 |
| Phone Number: | 3307584515 |
| Fax Number: | 3307582862 |
| NPI Enumeration Date: | 02/23/2010 |
| NPI Last Update Date: | 02/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 0810003939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |