Provider Demographics
NPI:1336233428
Name:WANAMAKER, CATHERINE E (PH D)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:E
Last Name:WANAMAKER
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CHILDRENS CENTER RD SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-2545
Mailing Address - Country:US
Mailing Address - Phone:703-777-3485
Mailing Address - Fax:703-777-4887
Practice Address - Street 1:801 CHILDRENS CENTER RD SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2545
Practice Address - Country:US
Practice Address - Phone:703-777-3485
Practice Address - Fax:703-777-4887
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002412103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist