Provider Demographics
NPI:1891271839
Name:KINDAICHI, MAI MARGARET (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAI
Middle Name:MARGARET
Last Name:KINDAICHI
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 1:14299A BRUSHWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2211
Mailing Address - Country:US
Mailing Address - Phone:202-234-7738
Mailing Address - Fax:
Practice Address - Street 1:1755 S ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6107
Practice Address - Country:US
Practice Address - Phone:202-234-7738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000783103T00000X
VA0810005100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical