Provider Demographics
NPI:1093163487
Name:ERAT, VICTORIA PEPE (PHD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PEPE
Last Name:ERAT
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 1:15316 EMORY LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1624
Mailing Address - Country:US
Mailing Address - Phone:301-873-7704
Mailing Address - Fax:
Practice Address - Street 1:15316 EMORY LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-1624
Practice Address - Country:US
Practice Address - Phone:301-873-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1683103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist