Provider Demographics
NPI:1972766087
Name:DOS SANTOS, LAURIE S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:S
Last Name:DOS SANTOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1390 CHAIN BRIDGE RD # 50032
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3904
Mailing Address - Country:US
Mailing Address - Phone:703-520-7878
Mailing Address - Fax:
Practice Address - Street 1:8504 LAROQUE RUN DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-1932
Practice Address - Country:US
Practice Address - Phone:703-520-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent