Provider Demographics
NPI:1821334772
Name:AIMONE, KYLA (PHD, LCP)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:AIMONE
Suffix:
Gender:F
Credentials:PHD, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N WASHINGTON ST
Mailing Address - Street 2:SUITE 304A
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3438
Mailing Address - Country:US
Mailing Address - Phone:773-469-2320
Mailing Address - Fax:
Practice Address - Street 1:300 N WASHINGTON ST
Practice Address - Street 2:SUITE 304A
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3438
Practice Address - Country:US
Practice Address - Phone:773-469-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004680103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent