Provider Demographics
NPI:1760948095
Name:SOSA-SARKAR, DANIELA (PSYD)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:SOSA-SARKAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:SOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:5500 HOLMES RUN PKWY STE C4
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5500 HOLMES RUN PKWY STE C4
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2860
Practice Address - Country:US
Practice Address - Phone:703-379-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006143103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty