| Doctor Name: | DR. JOHN JOSEPH GUALTIERI |
| NPI Number: | 1194868174 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH. D. |
| License Number: | 0810001429 |
| Business Practice Address: | 1515 Chain Bridge Rd Suite G14 Mclean, VA - 221014451 |
| Business Phone Number: | 7037908111 |
| Business Fax Number: | |
| Mailing Address: | 1515 Chain Bridge Rd, Suite G14 MCLEAN |
| State: | VA |
| Postal Code: | 22101 |
| Phone Number: | 7037908111 |
| Fax Number: | |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810001429 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |