Provider Demographics
NPI:1073188306
Name:COLTSON, DENISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:COLTSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:FEDLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8221 WILLOW OAKS CORPORATE DR STE 4-425
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4512
Mailing Address - Country:US
Mailing Address - Phone:703-289-7599
Mailing Address - Fax:703-289-4612
Practice Address - Street 1:8221 WILLOW OAKS CORPORATE DR STE 4-425
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4512
Practice Address - Country:US
Practice Address - Phone:703-289-7599
Practice Address - Fax:703-289-4612
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008091103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist