Provider Demographics
NPI:1801387311
Name:FARMAND, LAILA SALEM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAILA
Middle Name:SALEM
Last Name:FARMAND
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 1:2442 S WALTER REED DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-4090
Mailing Address - Country:US
Mailing Address - Phone:703-629-3870
Mailing Address - Fax:
Practice Address - Street 1:2200 WILSON BLVD STE 412
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3324
Practice Address - Country:US
Practice Address - Phone:571-328-7408
Practice Address - Fax:844-249-5577
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9475103T00000X
VA0810005857103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0810005857OtherN/A