Provider Demographics
NPI:1144596958
Name:MARINO, JOANNA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:MARIE
Last Name:MARINO
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 1:2001 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-3603
Mailing Address - Country:US
Mailing Address - Phone:571-257-3378
Mailing Address - Fax:571-257-0906
Practice Address - Street 1:2001 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 211
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3603
Practice Address - Country:US
Practice Address - Phone:571-257-3378
Practice Address - Fax:571-257-0906
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004487103TC0700X
DCPSY1000770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical