Doctor Name: | DR. STEPHANIE HUSIK TEBOR |
NPI Number: | 1023366200 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 0810003321 |
Business Practice Address: | 6723 Whittier Ave Suite 405-c Mc Lean, VA - 221014522 |
Business Phone Number: | 7035084836 |
Business Fax Number: | 7039088834 |
Mailing Address: | 6723 Whittier Ave, Suite 405-c MC LEAN |
State: | VA |
Postal Code: | 221014522 |
Phone Number: | 7035084836 |
Fax Number: | 7039088834 |
NPI Enumeration Date: | 08/21/2012 |
NPI Last Update Date: | 08/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0810003321 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |