Provider Demographics
NPI:1699220053
Name:WILLIAMS, AMANDA JOSLIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JOSLIN
Last Name:WILLIAMS
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 1:22587 AMENDOLA TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-3201
Mailing Address - Country:US
Mailing Address - Phone:979-318-2608
Mailing Address - Fax:
Practice Address - Street 1:20925 PROFESSIONAL PLZ STE 230
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3403
Practice Address - Country:US
Practice Address - Phone:703-621-7121
Practice Address - Fax:703-665-7686
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPPS-0605906103TS0200X
VA0810006195103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool