Provider Demographics
NPI:1952068256
Name:CONTRERAS, PATRICIA SUSANA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SUSANA
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42051 BARRYMOORE PL
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-6439
Mailing Address - Country:US
Mailing Address - Phone:703-869-7771
Mailing Address - Fax:
Practice Address - Street 1:42051 BARRYMOORE PL
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-6439
Practice Address - Country:US
Practice Address - Phone:703-869-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist