Provider Demographics
NPI:1922033414
Name:RACITI, MARIA C (PHD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:RACITI
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 1:4102 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2725
Mailing Address - Country:US
Mailing Address - Phone:757-877-0150
Mailing Address - Fax:757-877-0151
Practice Address - Street 1:4102 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2725
Practice Address - Country:US
Practice Address - Phone:757-877-0150
Practice Address - Fax:757-877-0151
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical