Provider Demographics
NPI:1598274037
Name:INGRAFFIA, TERESA MATOUS (PSYD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MATOUS
Last Name:INGRAFFIA
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 1:6400 ARLINGTON BLVD STE 920
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2336
Mailing Address - Country:US
Mailing Address - Phone:571-483-8395
Mailing Address - Fax:
Practice Address - Street 1:6400 ARLINGTON BLVD STE 920
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2336
Practice Address - Country:US
Practice Address - Phone:571-483-8395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005491103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical