| Doctor Name: | DR. LAURENCIA CDL DUSANTOS |
| NPI Number: | 1902074982 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 0810005067 |
| Business Practice Address: | 9404 Sunset Ct Apt 435 Manassas Park, VA - 201118292 |
| Business Phone Number: | 7853750375 |
| Business Fax Number: | |
| Mailing Address: | 9404 Sunset Ct, Apt 435 MANASSAS PARK |
| State: | VA |
| Postal Code: | 201118292 |
| Phone Number: | 7853750375 |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2008 |
| NPI Last Update Date: | 10/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810005067 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |