Most Relevant Information
Provider Data
| NPI Number: | 1003499393 |
| Provider Name: | JASON NORTHRUP PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 0810008024 |
Most Important Dates
| Enumeration Date: | 05/04/2021 |
| Last Updated: | 11/06/2024 |
Provider Practice Location
8928 FALLING CREEK CT
ANNANDALE
VA
220034108
Practice Location Phone/Fax
| Phone: | 5854144836 |
| Fax: |
Provider Mailing Location
8928 FALLING CREEK CT
ANNANDALE
VA
220034108
Provider Mailing Phone/Fax
| Phone: | 5854144836 |
| Fax: |