Dr. Amanda L Thompson, Ph.D.
Psychologist in Fairfax, VA. Individual provider (NPI-1).
NPI number1760614705
StatusActive
Last updated in NPPESApr 26, 2021
Details
- NPI
- 1760614705
- Entity type
- Individual (NPI-1)
- Name
- Dr. Amanda L Thompson
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 9, 2009
- Certification date
- Apr 26, 2021
- Last updated
- Apr 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 0810004239 | VA | Yes |
| 103TC2200X | Psychologist, Clinical Child & Adolescent | PSY1000568 | DC |
Practice location
8081 Innovation Park Dr Ste 2201Fairfax, VA 22031-4867
Phone 571-472-0767 · Fax 571-472-0377
Mailing address
Po Box 37174Baltimore, MD 21297-3174
Phone 571-423-5699 · Fax 571-423-5698
Other practice locations
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