Provider Demographics
NPI:1164636684
Name:KILLOUGH, CYNTHIA ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:KILLOUGH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 14TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4723
Mailing Address - Country:US
Mailing Address - Phone:703-989-9486
Mailing Address - Fax:
Practice Address - Street 1:1700 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 410
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1134
Practice Address - Country:US
Practice Address - Phone:202-483-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03950103T00000X
DC1000221103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical