Provider Demographics
NPI:1164632501
Name:FIRE, RENATA CERQUEIRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:RENATA
Middle Name:CERQUEIRA
Last Name:FIRE
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 1:100 N WASHINGTON ST
Mailing Address - Street 2:SUITE 238
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4523
Mailing Address - Country:US
Mailing Address - Phone:703-831-7514
Mailing Address - Fax:
Practice Address - Street 1:100 N WASHINGTON ST
Practice Address - Street 2:SUITE 238
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4523
Practice Address - Country:US
Practice Address - Phone:703-831-7514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist