Provider Demographics
NPI:1063685287
Name:SMITH, ALISON CORBETT (PHD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:CORBETT
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 CRESTMONT CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-3822
Mailing Address - Country:US
Mailing Address - Phone:703-690-3862
Mailing Address - Fax:
Practice Address - Street 1:133 PARK ST NE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4602
Practice Address - Country:US
Practice Address - Phone:703-281-4928
Practice Address - Fax:703-242-0014
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist